Clinical Profile and Outcomes of Term and Preterm Newborns Admitted to the NICU at a Tertiary Care Hospital

Open Access

Abstract

Background: The neonatal period remains the most vulnerable window for child survival, accounting for a disproportionate share of under-five mortality, with many deaths occurring in the first week of life. Preterm birth and its complications contribute substantially to neonatal morbidity and mortality, particularly in South Asia. In tertiary NICUs, term and preterm newborns often present with different illness patterns and care needs. The study aimed to describe and compare the clinical profiles and in-hospital outcomes of term and preterm newborns admitted to the NICU of a tertiary care hospital. Methods & Materials: This retrospective observational study was conducted in the neonatal intensive care unit (NICU) of a tertiary hospital in Bangladesh, over 12 months, from January 2023 to December 2023. All consecutive NICU admissions aged 0 to 28 days were screened, and 148 neonates with sufficient documentation were included. Maternal and perinatal details were extracted using a structured data sheet when available. The primary outcomes were discharge status and length of stay. Secondary outcomes included discharge weight and major morbidities, such as sepsis, respiratory disorders, hypoglycaemia, and jaundice requiring phototherapy. Data were analyzed using SPSS version 26 with descriptive statistics, and statistical significance was set at p<0.05. Results: Of 148 NICU admissions, 79 were preterm and 69 term. Preterm newborns had lower gestational age and birth weight (34.4 vs 37.0 weeks, 2189 vs 2751 g; both p<0.001), more grunting (48.1% vs 20.3%, p=0.001), and higher rates of prematurity or low birth weight and RDS (54.4% and 20.3% vs 7.2% and 0.0%; both p<0.001). Term newborns had more meconium aspiration or MAS (13.0% vs 1.3%, p=0.006; 17.4% vs 3.8%, p=0.012). Jaundice and sepsis were common in both groups, with high antibiotic and phototherapy use, while preterm newborns had longer hospital stay (4 vs 3 days, p=0.007) and lower discharge weight (2088 vs 2775 g, p<0.001). Conclusion: Preterm NICU admissions had lower gestational age and birth weight, greater respiratory morbidity, and longer hospital stay than term newborns, while term newborns had more meconium-related illness. High burdens of jaundice, suspected infection, and antibiotic use in both groups underscore the need for targeted prematurity prevention, standardized respiratory and jaundice protocols, and stronger infection diagnostics with antimicrobial stewardship in tertiary NICUs.