Transition from neonatal to paediatric intensive care of very preterm-born children: a cohort study of children born between 2013 and 2018 in England and Wales
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective Following very preterm birth, some children require ongoing intensive care after the neonatal period and transition directly from neonatal units (NNUs) to paediatric intensive care units (PICUs) around term-corrected age.
We aimed to understand, at a national level, characteristics and outcomes of children born very preterm who transitioned directly from NNUs to PICUs.
Design Retrospective cohort study, using data linkage of National Neonatal Research Database, Paediatric Intensive Care Audit Network and Office for National Statistics datasets.
Setting All NNUs and PICUs in England and Wales.
Patients Children born <32 gestational weeks between 1 January 2013 and 31 December 2018, admitted to NNUs, and who transitioned directly to PICU without return to NNU at ≥36 weeks corrected gestation age were included.
Main outcome measures Mortality, length of PICU stay, invasive ventilation in PICU (including via tracheostomy), PICU readmission until 2 years of age.
Results Direct NNU-to-PICU transitions occurred in 276 babies during the study period. An increasing yearly trend was observed: 36 transitions of babies born in 2013, 65 in 2018.
Of this cohort, 22% of children died before their second birthday, 59% of survivors had ≥1 PICU readmission, 33% of children had long stays in PICU (≥28 days) and 25% received tracheostomy ventilation.
Conclusions An increasing number of very preterm children require ongoing intensive care at the end of their neonatal stay, with high rates of mortality and morbidity. Multidisciplinary involvement and planning around the time of transition from NNU to PICU, informed by national guidance, may be beneficial.
We aimed to understand, at a national level, characteristics and outcomes of children born very preterm who transitioned directly from NNUs to PICUs.
Design Retrospective cohort study, using data linkage of National Neonatal Research Database, Paediatric Intensive Care Audit Network and Office for National Statistics datasets.
Setting All NNUs and PICUs in England and Wales.
Patients Children born <32 gestational weeks between 1 January 2013 and 31 December 2018, admitted to NNUs, and who transitioned directly to PICU without return to NNU at ≥36 weeks corrected gestation age were included.
Main outcome measures Mortality, length of PICU stay, invasive ventilation in PICU (including via tracheostomy), PICU readmission until 2 years of age.
Results Direct NNU-to-PICU transitions occurred in 276 babies during the study period. An increasing yearly trend was observed: 36 transitions of babies born in 2013, 65 in 2018.
Of this cohort, 22% of children died before their second birthday, 59% of survivors had ≥1 PICU readmission, 33% of children had long stays in PICU (≥28 days) and 25% received tracheostomy ventilation.
Conclusions An increasing number of very preterm children require ongoing intensive care at the end of their neonatal stay, with high rates of mortality and morbidity. Multidisciplinary involvement and planning around the time of transition from NNU to PICU, informed by national guidance, may be beneficial.
Date Issued
2025-07-01
Date Acceptance
2024-11-16
Citation
Archives of Disease in Childhood: Fetal and Neonatal Edition, 2025, 110 (4), pp.369-376
ISSN
1359-2998
Publisher
BMJ Publishing Group
Start Page
369
End Page
376
Journal / Book Title
Archives of Disease in Childhood: Fetal and Neonatal Edition
Volume
110
Issue
4
Copyright Statement
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
License URL
Identifier
10.1136/archdischild-2024-327457
Publication Status
Published
Date Publish Online
2024-12-09