Neonatal Intensive Care Unit Outcomes and Resource Use Among Extremely Preterm Survivors

Temesgen Getaneh; Nusrat Homaira; Prudence Creighton; Giannina Tinoco Mendoza; Abrar Ahmad Chughtai; Georgina Chambers; Kei Lui; Australian and New Zealand Neonatal Network

doi:10.1111/apa.70355

Neonatal Intensive Care Unit Outcomes and Resource Use Among Extremely Preterm Survivors

Acta Paediatr. 2026 Feb;115(2):450-459. doi: 10.1111/apa.70355. Epub 2025 Oct 17.

Authors

Temesgen Getaneh^{1

2}, Nusrat Homaira^{1

3

4}, Prudence Creighton⁵, Giannina Tinoco Mendoza^{1

6}, Abrar Ahmad Chughtai⁷, Georgina Chambers⁸, Kei Lui^{1

5

6}; Australian and New Zealand Neonatal Network

Affiliations

¹ Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW, Randwick, Sydney, Australia.
² College of Health Science, Midwifery Department, Debre Markos University, Debre Markos, Ethiopia.
³ Respiratory Department, Sydney Children's Hospital, UNSW, Randwick, Sydney, Australia.
⁴ James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
⁵ Australian and New Zealand Neonatal Network, UNSW, Sydney, Australia.
⁶ Department of Newborn Care, the Royal Hospital for Women, UNSW, Sydney, Australia.
⁷ School of Population Health, UNSW, Kensington Campus, Sydney, Australia.
⁸ Centre for Big Data Research in Health and School of Clinical Medicine, UNSW, Sydney, Australia.

PMID: 41108206
DOI: 10.1111/apa.70355

Abstract

Aim: Survival outcomes and use of neonatal intensive care (NICU) were evaluated among extremely preterm (EPT) infants cared for in Australia and New Zealand NICUs.

Methods: Retrospective analysis of prospectively collected data from the Australian and New Zealand Neonatal Network was conducted for infants born at 22-27 weeks of gestation and admitted and cared for in 29 NICUs between 1 January 2018 and 31 December 2022.

Results: Of the 5414 EPT infants, 83.1% survived and 63.7% without any major morbidities. Antenatal steroid use was low at 22-23 weeks of gestation, although there was an increase in survival from 40.2% in 2018 to 51.9% in 2022. Survival with major morbidities increased from 33.9% in 2018 to 39.1% in 2022 (p = 0.013), driven by significant increases in bronchopulmonary dysplasia (BPD) (17.4% to 21.2%) and retinopathy of prematurity (ROP) (14.5% to 17.7%). Survivors with major morbidities had significantly higher use of mechanical ventilation (median hours and IQR 347, 122-671 vs. 67, 19-198) and parenteral nutrition (488, 285-804 vs. 275, 196-420 h) than those without.

Conclusion: Survival with major morbidities increased from 2018 to 2022, driven by increases in BPD and ROP. Infants with major morbidities required more intensive care across all gestation.

Keywords: bronchopulmonary dysplasia; extremely preterm infants; neonatal intensive care use; retinopathy of prematurity; survival outcomes.

MeSH terms

Australia / epidemiology
Female
Humans
Infant, Extremely Premature*
Infant, Newborn
Intensive Care Units, Neonatal* / statistics & numerical data
Male
New Zealand / epidemiology
Retrospective Studies