Medical Student Frank H. Netter MD School of Medicine at Quinnipiac University Worcester, Massachusetts, United States
Background: Achievement of maturational milestones are commonly used in Neonatal Intensive Care Units (NICUs) to determine discharge eligibility in preterm infants. Due to the multisystem immaturity infants born preterm and prolonged hospitalization, they must demonstrate adequate cardiorespiratory regulation, oral feeding, and thermoregulation prior to NICU discharge. Previous research has described the typical chronology of maturational milestone achievement, but it is unclear whether there are demographic, social, or clinical predictors of the order and timing. Objective: The objective is to examine the association(s) between demographic, social, and clinical factors on the timing of maturational milestone achievement among preterm infants admitted to a Level III NICU. Design/Methods: This is a retrospective cohort study of all infants born less than 30 weeks gestation who were admitted to the UMass Memorial Medical Center (UMMMC) NICU from October 2017 through March 2023. This study was approved by the UMass Chan IRB. Demographic and clinical variables will be abstracted from the infant’s and birthing parent’s electronic medical records. To assess maturational milestone achievement, dates of the following will be obtained: last CPAP use, last dose of caffeine for apnea of prematurity, last oxygen use (any respiratory support with > 21% FiO2), last use of a thermoregulation device (isolette, warmer), last feeding via nasogastric tube, last apnea/bradycardia/desaturation event requiring intervention (stimulation, position change), and NICU discharge. All dates will be converted to corrected gestational age (CGA) for analysis. Infants will be categorized into four groups based on their last maturational milestone that was achieved: cardiorespiratory, feeding, and simultaneous (two or more maturational milestones met within 24 hours). Multivariable logistic regression analysis will be performed to identify potential predictors of the final maturational milestone achieved. We plan to complete data collection by December 15, 2023, and complete data analysis by February 15, 2024.
