ArticleJAMA network open2024
Neonatal Intensive Care Unit Resource Use for Infants at 22 Weeks' Gestation in the US, 2008-2021.
Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed.
- Infants ≤24 weeks are not just smaller extremely preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Climate change literacy and environmental stewardship in neonatal intensive care: a mixed-methods study of nursing practice patterns.BMC nursing · 2026Article
- Association of Intended Mode of Delivery With Neonatal and Maternal Outcomes at 22-25 Weeks of Gestation.O&G open · 2026Article
- Ventilatory support in neonates with cancer: balancing oxygen and oncologic stability.Annals of medicine and surgery (2012) · 2025Article
- Meconium obstruction of prematurity in tiny babies - towards developing an international consensus.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Variation in NICU utilization: a narrative review and path forward.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Outcomes of extremely preterm infants exposed to prolonged prelabor rupture of membranes before 24 weeks of gestation.American journal of obstetrics and gynecology · 2025Article
- Approaches to incubator humidification at <25 weeks' gestation and potential impacts on infants.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- It's the little things. A framework and guidance for programs to care for infants 22-23 weeks' gestational age.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- The impact of standardization of care for neonates born at 22-23 weeks gestation.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- In-utero transfer, survival-focused care and survival to 28-days at 22-24 weeks' gestation pre- and post- implementation of an extreme prematurity management guideline in Victoria, Australia.BMJ paediatrics open · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Importance: During the past decade, clinical guidance about the provision of intensive care for infants born at 22 weeks' gestation has changed. The impact of these changes on neonatal intensive care unit (NICU) resource utilization is unknown. Objective: To characterize recent trends in NICU resource utilization for infants born at 22 weeks' gestation compared with other extremely preterm infants (≤28 weeks' gestation) and other NICU-admitted infants. Design, Setting, and Participants: This is a serial cross-sectional study of 137 continuously participating NICUs in 29 US states from January 1, 2008, through December 31, 2021. Participants included infants admitted to the NICU. Data analysis was performed from October 2022 to August 2023. Exposures: Year and gestational age at birth. Main Outcomes and Measures: Measures of resource utilization included NICU admissions, NICU bed-days, and ventilator-days. Results: Of 825 112 infants admitted from 2008 to 2021, 60 944 were extremely preterm and 872 (466 [53.4%] male; 18 [2.1%] Asian; 318 [36.5%] Black non-Hispanic; 218 [25.0%] Hispanic; 232 [26.6%] White non-Hispanic; 86 [9.8%] other or unknown) were born at 22 weeks' gestation. NICU admissions at 22 weeks' gestation increased by 388%, from 5.7 per 1000 extremely preterm admissions in 2008 to 2009 to 27.8 per 1000 extremely preterm admissions in 2020 to 2021. The number of NICU admissions remained stable before the publication of updated clinical guidance in 2014 to 2016 and substantially increased thereafter. During the study period, bed-days for infants born at 22 weeks increased by 732%, from 2.5 per 1000 to 20.8 per 1000 extremely preterm NICU bed-days; ventilator-days increased by 946%, from 5.0 per 1000 to 52.3 per 1000 extremely preterm ventilator-days. The proportion of NICUs admitting infants born at 22 weeks increased from 22.6% to 45.3%. Increases in NICU resource utilization during the period were also observed for infants born at less than 22 and at 23 weeks but not for other gestational ages. In 2020 to 2021, infants born at less than or equal to 23 weeks' gestation comprised 1 in 117 NICU admissions, 1 in 34 of all NICU bed-days, and 1 in 6 of all ventilator-days. Conclusions and Relevance: In this serial cross-sectional study of 137 US NICUs from 2008 to 2021, an increasing share of resources in US NICUs was allocated to infants born at 22 weeks' gestation, corresponding with changes in national clinical guidance.
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