title: Determination of antepartum and intrapartum risk factors associated with neonatal intensive care unit admission.
abstract: OBJECTIVE
  To determine antepartum and intrapartum factors that are associated with admission to neonatal intensive care unit (NICU) among infants delivered between 36.0 and 42.0 weeks at our institution.
  
  
  METHODS
  The retrospective cohort study included 73 consecutive NICU admissions and 375 consecutive non-NICU admissions. Data on demographic, antepartum, intrapartum and neonatal factors were collected. The primary endpoint defined was admission to NICU. Univariate analyses using the Student's t-test, Mann-Whitney U-test, χ2 Fisher's exact test was performed along with multivariate analysis of significant non-redundant variables.
  
  
  RESULTS
  Those with a significantly higher risk of NICU admission underwent induction of labor with prostaglandin analogs (12.5% vs. 24.7%, P=0.007). Length of first stage ≥720 min (33.5% vs. 51.9%, P=0.011), length of second stage of labor ≥240 min (10.6% vs. 31.6%, P<0.001) and prolonged rupture of membranes ≥120 min (54.0% vs. 80.0%, P=0.001) were all associated with an increased chance of NICU admission. Intrapartum factors predictive of NICU admission included administration of meperidine (11.7% vs. 27.4%, P<0.001), presence of preeclampsia (5.5% vs. 0.8%, P=0.015), use of intrapartum IV antihypertensives (1.1% vs. 13.7%, P<0.001), maternal fever (5.3% vs. 31.5%, P<0.001), fetal tachycardia (1.9% vs. 12.3%, P<0.001), and presence of meconium (30% vs. 8%, P<0.001).
  
  
  CONCLUSIONS
  Identification of modifiable risk factors may reduce neonatal morbidity and mortality. Results from this study can be used to develop and validate a risk model based on combined antepartum and intrapartum risk factors.
authors.forename: Angela P H
authors.initials: AP
authors.lastname: Burgess
authors.forename: Justin
authors.initials: J
authors.lastname: Katz
authors.forename: Joanna
authors.initials: J
authors.lastname: Pessolano
authors.forename: Jane
authors.initials: J
authors.lastname: Ponterio
authors.forename: Michael
authors.initials: M
authors.lastname: Moretti
authors.forename: Nisha A
authors.initials: NA
authors.lastname: Lakhi
mesh_terms: D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000503:physiopathology; D005334:Fever / Q000150:complications; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007751:Labor, Induced / Q000009:adverse effects; D008297:Male; D009017:Morbidity; D009519:New York City / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers