Impact of the COVID-19 pandemic on preterm births, neonatal morbidities, and short-term outcomes in two Indian tertiary neonatal intensive care units: a retrospective study

Rachana R. D.; Praveen Rao Vadije; Jyothsna P.; Venkateshwarlu V.; Sai Kiran D.; Tejo Pratap Oleti; Sreeram Subramanian; Bangaru Elisha Joel; Shruthi T.; Sumayya Hafeez; Srinivas Murki

doi:10.18203/2349-3291.ijcp20252223

Authors

Rachana R. D. Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
Praveen Rao Vadije Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
Jyothsna P. Department of Neonatology, Paramitha Children’s Hospital, Hyderabad, Telangana, India
Venkateshwarlu V. Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
Sai Kiran D. Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
Tejo Pratap Oleti Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
Sreeram Subramanian Department of Neonatology, Paramitha Children’s Hospital, Hyderabad, Telangana, India
Bangaru Elisha Joel epartment of Neonatology, Paramitha Children’s Hospital, Hyderabad, Telangana, India
Shruthi T. Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
Sumayya Hafeez Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
Srinivas Murki Department of Neonatology, Paramitha Children’s Hospital, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20252223

Keywords:

COVID-19, Preterm birth, NICU admissions, Neonatal morbidity, Neonatal outcomes

Abstract

Background: The COVID-19 pandemic has had a global impact, with variable effects on preterm birth rates. This study compared preterm admissions, neonatal morbidities, and short-term outcomes among NICU admissions in the pre-COVID-19 and COVID-19 eras.

Methods: A retrospective analysis was conducted of neonates admitted to two tertiary neonatal intensive care units (NICUs) in India between March 2019 and February 2021. Admissions were categorized as pre-COVID-19 (March 2019–February 2020) and COVID-19 era (March 2020–February 2021). Exclusions included major congenital anomalies, readmissions, neonates <25 weeks or <500 g, and SARS-CoV-2 positive mother-neonate pairs. Interrupted time series analysis (ITS) was used to assess trends in preterm admissions.

Results: Of 3,513 neonates, 1,847 were admitted in the pre-COVID-19 era and 1,666 during the COVID-19 era-a 9.8% decrease. Preterm admissions declined from 45.6% to 41.9% (3.7% absolute reduction, p=0.02). ITS analysis showed a decline of 0.2 preterm admissions per week during the COVID-19 era (p<0.05). Neonates in the COVID-19 era had higher mean gestational age (36.2±2.9 vs. 35.9±2.9 weeks, p=0.001) and birth weight (2,512±731 vs. 2,441±725 g, p=0.006). Admissions due to transient tachypnea of the newborn (TTN) increased from 26% to 31.8% of all NICU admissions (p<0.001), while the incidence of any sepsis (suspect, probable, or culture-proven) declined from 25.8% to 19.3% (p<0.001). The neonatal mortality rate remained stable across both periods (1.4% vs. 1.6%, p=0.6).

Conclusions: The COVID-19 era was associated with a reduction in preterm admissions across our two tertiary NICUs, consistent with global trends. Short-term outcomes, including mortality and major morbidities, remained largely unchanged.

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