Ong IYE, Tan MGS and Shah VA*
Department of Neonatology and Developmental Medicine, Singapore General Hospital, SingaporeFulltext PDF
Objectives: A retrospective cohort study was performed to evaluate the outcomes of asymptomatic term newborns admitted based on maternal risk factors to the Neonatal High Dependency (HD) unit of a tertiary center in Singapore. The data was used to evaluate the appropriateness of the unit’s current HD admission criteria and identify risk factors which were predictive for newborns turning unwell during the HD monitoring period. Methods: Anonymized clinical information of all live births in the unit were reviewed from April to June 2022. All term newborns admitted to the unit were included in the analysis. Maternal demographics, fetal characteristics, maternal and fetal risk factors, and neonatal outcomes were also retrieved from the clinical notes. Results: Out of the total of 95 asymptomatic term newborns admitted to HD for observation during the study period, only 16% turned symptomatic during the six-hour observation period. Of these, a roughly equal proportion had single (53%) and 2 or more risk factors (47%). Most asymptomatic term newborns who remained well until discharge had only 1 risk factor (59%). Conclusion: Our results are consistent with current literature that most asymptomatic newborns of mothers with risk factors remained well post-natally. Admitting these newborns to the nursery instead would decrease use of hospital resources and bill size, while promoting skin to skin contact at birth, rooming in of newborn with mother and increasing breastfeeding rate, satisfying the ten steps of Baby Friendly Hospital Initiatives (BFHI). HD nurses can also focus care on sicker newborns requiring closer monitoring.
Neonatology; High-dependency; Admission criteria; Asymptomatic; Full-term
Ong IYE, Tan MGS, Shah VA. A Review of the Singapore General Hospital Neonatology Unit High Dependency Admission Criteria. Ann Pediatr Res. 2023; 7(2): 1076..