794 - Higher NICU admissions during the COVID-19 Pandemic

Increasing evidence has shown that the COVID-19 pandemic has had profound negative impact on vulnerable populations. 

Objective:

Our goal is to assess the effect of the pandemic on the neonatal outcomes.

Design/Methods:

This is a retrospective study in a public hospital, between pre-COVID-19 (January 2018, to December 2019) and COVID-19 (January 2020 to December 2021).  Data were obtained from all livebirths at >/= 35weeks gestation (GA).  Maternal and neonatal demographics, delivery room (DR) and NICU neonatal outcomes were compared between the study periods using chi square, test, and Wilcoxon (Mann-Whitney) rank-sum test.  Multivariate logistic regression analysis was performed to adjust for the effects of baseline differences in demographics on the outcomes.

Results:

A total of 11,383 infants were born during the study period (pre-COVID-19 n=5842, COVID-19 n=5540).  During the COVID-19 period (Table1), there was a significant but very small decrease in GA (0.2weeks) and the birth weight (50g); increase in maternal diabetes (3.2%), hypertension (4.1%), pre-pregnancy BMI (0.3) and Hispanics (4.5%).   There was a decrease in infants who received 1 minute (96.5% vs. 95.2%) and 3 minutes (75.5% vs. 68.9%) of delayed cord clamping (DCC), infants who received chest compressions (0.1% vs. 0.02%) and increase in the exclusive breastfeeding rate (65.6% vs. 69.6%), metabolic acidosis (0.7% vs. 1.1%), NICU admission (5.1% vs. 6.6%), antibiotic use (0.7% vs. 1.7%), and respiratory support (2.1% vs. 2.7%) (Table 2).  These differences in DR and NICU outcomes were significant even after adjusting for GA, maternal diabetes, and hypertension.  Maternal hypertension was an independent risk factor for all of these outcomes.

Conclusion(s):

In the COVID-19 pandemic period, we observed a significant increase in overall exclusive breastfeeding, NICU admissions, use of antibiotics and respiratory support in NICU. While the adverse neonatal outcomes during the COVID-19 pandemic were only partly explained by maternal morbidities like hypertension, socio-economic factors and other social determinants of health need to be further explored.