Length of Stay and Associated Factors in the Neonatal Intensive Care Units in Central Saudi Arabia: A Retrospective Study

Background: Global improvements in neonatal survival have been associated with increased admissions of preterm infants to neonatal intensive care units (NICUs) and longer hospital stays. However, data on the length of stay (LOS) for infants in NICUs and related factors in Saudi Arabia are scarce. This study aimed to evaluate the LOS and its associated factors in the NICUs in Central Saudi Arabia. Methods: In 2023, a retrospective study was conducted in the NICU of King Saud Hospital in Unaizah, Qassim region, Saudi Arabia. Neonatal and maternal information was gathered from medical records using questionnaires. Modified Poisson regression models were generated, providing relative risk and a 95.0% confidence interval. Results: A total of 915 neonates (53.6% males vs 46.4% females) were included in this analysis. Of these, 293 (32.0%) were low birth weight (LBW), 270 (29.5%) were preterm, and 51 (5.6%) had hypothermia. The median interquartile range (IQR) for the neonates’ white blood cell (WBC) count and red cell distribution width (RDW) was 13.8% (10.7–17.8%) and 16.7% (15.4–18.1%) × 10³/mm³, respectively. Their LOS ranged from 1 to 47 days, with a mean of 5.5 days, a median (IQR) of 3.0 (2–6) days, and a 90th percentile of 12 days. Multivariate Poisson analysis indicated that cesarean delivery (aRR = 1.38, 95% CI = 1.30–1.47), preterm delivery (adjusted relative risk [aRR] = 1.93, 95% CI = 1.79–2.07), LBW (aRR = 1.63, 95% CI = 1.51–1.74), and RDW (aRR = 1.02, 95% CI = 1.01–1.03) were positively associated with LOS, while neonatal jaundice (aRR = 0.74, 95% CI = 0.65–0.85) and WBC count (aRR = 0.99, 95% CI = 0.98 –0.99) were negatively associated. Conclusion: The average LOS in this study was 5.5 days. The identified factors could help healthcare providers predict neonatal LOS, thereby enhancing neonatal care management.