233 - Outcomes of neonates admitted to the NICU during the COVID-19 pandemic: Comparison with a pre-pandemic cohort

Poster Number: 233
Publication Number: 233.143

MARSHA CAMPBELL-YEO, Dalhousie University Faculty of Health, Tantallon, NS, Canada; Fabiana Bacchini, Canadian Premature Babies Foundation, Etobicoke, ON, Canada; Marc Beltempo, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Lynsey R. Alcock, IWK Health, Halifax, NS, Canada; Prakesh S. Shah, Mount Sinai Hospital, Toronto, ON, Canada

Background: Many neonatal intensive care unit (NICU) restrictions and policies were put in place during the COVID-19 pandemic to prevent infectious disease spread and safeguard the health of infants admitted to the NICU. The effect of the COVID-19 pandemic on neonatal outcomes in Canadian NICUs during this time is not yet completely understood.

Objective:

To investigate neonatal outcomes of very preterm infants admitted to Canadian NICUs during the COVID-19 pandemic, as compared to pre-pandemic.

Design/Methods:

This was a retrospective cohort study including infants born < 33 weeks and admitted to tertiary Canadian NICUs participating in the Canadian Neonatal Network (CNN) database. The sample included 14,368 infants divided into two cohorts: 7,280 infants pre-pandemic (April 1, 2018 – December 31, 2019) and 7,088 infants during the pandemic (April 1, 2020 – December 31, 2021). Primary composite outcomes were mortality or major morbidity (bronchopulmonary dysplasia, severe neurological injury, necrotizing enterocolitis, or retinopathy of prematurity). In addition, care practices and interventions were also compared between periods. Relative risk (RR) comparing the pandemic vs pre-pandemic periods were estimated using generalized estimated equations and adjusted for patient confounders.

Results:

There were minor differences in the characteristics of infants admitted before and during the pandemic (Table 1). The incidence of mortality or major morbidity was 37% (2667/7280) pre-pandemic and 36% (2561/7088) during the pandemic (adjusted RR = 1.01, 95% CI = 0.92 – 1.10). Crude and adjusted rates of individual morbidities did not significantly differ between periods (Table 2).

The duration of respiratory support was one day longer for infants during the pandemic (adjusted RR of medians = 1.00, 95% CI = 0.46 - 1.54). Other infant health outcomes were not significantly different between groups, including intubation, chest compression, normal admission temperature, and length of stay. There was a non-significant decrease in the exclusive receipt of mothers’ own milk at discharge during the COVID-19 pandemic, compared to pre-pandemic (RR = 0.85, 95% CI = 0.68 – 1.06).

Conclusion(s):

There was no difference in any of the clinical outcomes between pre-pandemic and pandemic cohorts of neonates admitted to Canadian NICUs. The possibility of lower receipt of exclusive mothers’ own milk at discharge during the COVID-19 pandemic needs to be studied further from other cohorts.