Gestational age-based outcomes of neonates with Down syndrome in the neonatal intensive care unit (NICU): review of pediatric health information system (PHIS) database.
Emily A Messick, Stephen A Hart, Julie Strominger, Sara Conroy, Carl H Backes, Clifford L Cua
{"title":"Gestational age-based outcomes of neonates with Down syndrome in the neonatal intensive care unit (NICU): review of pediatric health information system (PHIS) database.","authors":"Emily A Messick, Stephen A Hart, Julie Strominger, Sara Conroy, Carl H Backes, Clifford L Cua","doi":"10.1038/s41372-025-02384-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To examine differences in neonatal intensive care unit (NICU) outcomes in neonates with Down syndrome (DS) by gestational age (GA) using a large national database STUDY DESIGN: Retrospective analysis of Pediatric Health Information System database, including neonates with DS admitted to the NICU <30 days old from 1/1/2008-12/31/2022. Neonates were stratified by GA (extremely preterm, very preterm, moderate/late preterm, term). GA-based risk differences were examined for NICU outcomes using term neonates as reference.</p><p><strong>Results: </strong>Overall mortality rate was 7% with increasing mortality as GA decreased (RD 6.1 [95% CI 4.8, 7.5], RD 25.4 [95% CI 20.5, 30.6], RD 36.8 [95% CI 27.3, 46.8] for moderate/late preterm, very preterm, extremely preterm). The overall rate of pulmonary hypertension was 23% and 14% of the cohort required a gastrostomy tube.</p><p><strong>Conclusion: </strong>Prematurity significantly increases risk of NICU mortality for neonates with DS. Rates of pulmonary hypertension and gastrostomy were high throughout all groups.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41372-025-02384-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To examine differences in neonatal intensive care unit (NICU) outcomes in neonates with Down syndrome (DS) by gestational age (GA) using a large national database STUDY DESIGN: Retrospective analysis of Pediatric Health Information System database, including neonates with DS admitted to the NICU <30 days old from 1/1/2008-12/31/2022. Neonates were stratified by GA (extremely preterm, very preterm, moderate/late preterm, term). GA-based risk differences were examined for NICU outcomes using term neonates as reference.
Results: Overall mortality rate was 7% with increasing mortality as GA decreased (RD 6.1 [95% CI 4.8, 7.5], RD 25.4 [95% CI 20.5, 30.6], RD 36.8 [95% CI 27.3, 46.8] for moderate/late preterm, very preterm, extremely preterm). The overall rate of pulmonary hypertension was 23% and 14% of the cohort required a gastrostomy tube.
Conclusion: Prematurity significantly increases risk of NICU mortality for neonates with DS. Rates of pulmonary hypertension and gastrostomy were high throughout all groups.
目的:利用大型国家数据库,研究不同胎龄(GA)的唐氏综合征(DS)新生儿重症监护病房(NICU)预后的差异。研究设计:回顾性分析儿科健康信息系统数据库,包括入住NICU的DS新生儿。总死亡率为7%,死亡率随着GA的降低而增加(中度/晚期早产、非常早产和极度早产的RD为6.1 [95% CI 4.8, 7.5], RD为25.4 [95% CI 20.5, 30.6], RD为36.8 [95% CI 27.3, 46.8])。肺动脉高压的总体发生率为23%,14%的队列需要胃造口管。结论:早产显著增加DS新生儿在NICU死亡的风险。肺动脉高压和胃造口术的发生率在所有组中都很高。
期刊介绍:
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.