Very preterm, very low birth weight infants not admitted to the neonatal intensive care unit, National Vital Statistics Surveillance Data, United States 2021

The objective of this analysis is to examine characteristics of very preterm (VPT), very low birth weight (VLBW) infants not admitted to neonatal intensive care units (NICU). In this cross-sectional study assessing VPT (<32 weeks gestation) and VLBW (<1500 grams) infants, we used birth records from the National Vital Statistics System, 2021. Crude and adjusted prevalence ratios (aPR) with modified Poisson regression models were used to calculate prevalence of infants not admitted to the NICU by selected characteristics. Among 38,693 VPT, VLBW infants, 10% were not admitted to the NICU. In the adjusted model, characteristics associated with a higher prevalence of not being admitted to the NICU compared with analytical reference groups included non-Hispanic Native Hawaiian/Other Pacific Islander (aPR = 1.61;95% confidence interval [CI]:1.13-2.29), gestational age 22-24 weeks (aPR = 1.17;CI:1.08-1.26), vaginal delivery (aPR = 1.83;CI:1.73-1.94), and 5-minute Apgar score of 0-3 (aPR = 3.48;CI:3.18-3.82). Exploration of reasons infants were not admitted to the NICU may elucidate strategies to address barriers.