If you feel like you've heard about more babies ending up in the neonatal intensive care unit (NICU) these days, you may be on to something. According to a new study published online today in JAMA Pediatrics, admission rates in the U.S. are up in this highly specialized unit.
Perhaps most surprisingly, the increase is evident among all birth weight categories, including normal-sized newborns who were born at term.
Researchers discovered that overall NICU admission rates shot up from 64.0 to 77.9 per 1,000 live births. Between 2007 and 2012, more and more newborns of higher birth weights were being admitted there; by 2012, babies of normal birth weight or born at 37 weeks gestation or older made up almost half of the admission. Or, put another way, for every 1,000 newborns of normal birth weight, 43 were admitted into the NICU, notes the study's authors Wade Harrison, M.P.H., and David Goodman, M.D., M.S., of the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine. Meanwhile, for every 1,000 newborns of very low birth weight, 844.1 were admitted to the NICU.
The findings are based on data from nearly 18 million live births between January 2007 and December 2012, in 38 states and Washington, D.C.
Does this rise mean doctors are sending some newborns to the neonatal intensive care unit unnecessarily? Are they overusing the pricey (and precious) resources there? Based on their evidence, Drs. Harrison and Goodman couldn't say for sure, though they did suggest that "our findings raise questions about how this high-intensity resource is being used."
It's a topic worth considering, Aaron E. Carroll, M.D., M.S., of the Indiana University School of Medicine wrote in a related editorial—though not because of possible fraud or waste. Rather, it's because taking care of an infant in this specialized unit is expensive and carries "potential harm," he wrote. "If hospitals want to argue that NICUs are necessary, they will need to prove that the need exists, especially in light of the increasing share of infants admitted who are at or near full term. If hospitals are unable to demonstrate that NICUs are necessary, then it is very likely that, at some point in the near future, policies will force them to reduce those admissions, which will have major implications for NICU and hospital finances."
And that's something no parent should ever have to worry about.
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Bonnie Gibbs Vengrow is a New York City-based writer and editor who traded in her Blackberry and Metro card for playdates and PB&J sandwiches—and the once-in-a-lifetime chance to watch her feisty, funny son grow up. Follow her on Twitter, Pinterest, and Google+.
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