[Mortality and morbidity among full-term neonates in a neonatal intensive care unit in the Utrecht region, the Netherlands].
OBJECTIVE
To gain an insight into perinatal mortality and morbidity in full-term infants without congenital abnormalities admitted to a neonatal intensive care unit (NICU).


METHODS
Retrospective analysis.


METHODS
In this study, all full-term infants, who were born in the period 1997-2003 without congenital disorders and admitted to the NICU at the Wilhelmina Children's Hospital in Utrecht, the Netherlands were included. Information about the delivery, NICU-admission and follow-up until the age of 18 months was obtained from the hospital charts.


RESULTS
In total 597 full-term neonates were admitted to the NICU during the study period; this is equivalent to 3-4 per 1,000 full-term neonates in the Utrecht region. Of these, 47% were admitted on account of asphyxia, 17% with respiratory problems and 12% with infections. In 79% of all NICU admissions the delivery had taken place under secondary care; in 29% labour had started under exclusive care of a primary level midwife, because the pregnancy had been defined as low-risk. 21% of the neonates were admitted to the NICU following delivery under exclusive primary care. Almost 15% of the infants died in the NICU, in 89% due to asphyxia. Of the surviving infants following perinatal asphyxia, 15% had a permanent disability at the age of 18 months.


CONCLUSIONS
Post-partum admission of a fundamentally healthy full-term neonate to the NICU is a serious adverse perinatal outcome, and warrants further investigation. The various factors that influence these admissions should be analysed in more detail, for instance by means of perinatal audits.
Evers
Annemieke C C
AC
Universitair Medisch Centrum Utrecht, locatie Wilhelmina Kinderziekenhuis, divisie Vrouw en Baby, Utrecht, The Netherlands. A.Evers@umcutrecht.nl
van Leeuwen
Jeanette
J
Kwee
Anneke
A
Brouwers
Hens A A
HA
Koopman-Esseboom
Corine
C
Nikkels
Peter G J
PG
Duyn
Annette
A
Bruinse
Hein W
HW
D001238:Asphyxia Neonatorum / Q000401:mortality*; D001724:Birth Weight; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007239:Infections / Q000401:mortality; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D012140:Respiratory Tract Diseases / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors