ArticleJournal of perinatology : official journal of the California Perinatal Association2026
Prediction of outcomes for premature infants referred to a quaternary NICU for respiratory escalation.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo identify predictors of death or tracheostomy in preterm infants referred to quaternary Neonatal Intensive Care Unit (NICU) for respiratory escalation at ≥34 weeks postmenstrual age (PMA).
methodsSingle-center 13-year retrospective review of infants born <30 weeks gestation referred from Level III NICUs at ≥34 weeks PMA. Multivariable logistic regression identified independent predictors of death or tracheostomy.
resultsOf 91 infants (mean GA 25.4 weeks), 48.4% reached the primary outcome; 15 died. Later PMA at admission and higher respiratory support were independent predictors of the primary outcome (AUC: 0.826; 95% CI 0.74-0.91). Redirection of care preceded 53% of deaths. At discharge, 86.8% of survivors required positive pressure or supplemental oxygen.
conclusionsNearly half of infants who had "late referrals" for respiratory escalation experienced death or tracheostomy. Admission PMA and ventilation mode provide prognostic value, facilitating timely multidisciplinary counseling and decision-making regarding long-term ventilatory support.
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