{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:38:39Z","timestamp":1792103919122,"version":"4.4.0"},"reference-count":36,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: Neonatal intensive care unit (NICU) admission among term neonates is associated with significant morbidity and mortality, as well as high healthcare costs. A comprehensive NICU admission risk assessment using an integrated statistical approach for this rare admission event may be used to build a risk calculation algorithm for this group of neonates prior to delivery. Methods: A single-center case\u2013control retrospective study was conducted between August 2005 and December 2019, including in-hospital singleton live born neonates, born at \u226537 weeks\u2019 gestation. Analyses included univariate and multivariable models combined with the machine learning gradient-boosting model (GBM). The primary aim of the study was to identify and quantify risk factors and causes of NICU admission of term neonates. Results: During the study period, 206,509 births were registered at the Shaare Zedek Medical Center. After applying the study exclusion criteria, 192,527 term neonates were included in the study; 5292 (2.75%) were admitted to the NICU. The NICU admission risk was significantly higher (ORs [95%CIs]) for offspring of nulliparous women (1.19 [1.07, 1.33]), those with diabetes mellitus or hypertensive complications of pregnancy (2.52 [2.09, 3.03] and 1.28 [1.02, 1.60] respectively), and for those born during the 37th week of gestation (2.99 [2.63, 3.41]; p &lt; 0.001 for all), adjusted for congenital malformations and genetic syndromes. A GBM to predict NICU admission applied to data prior to delivery showed an area under the receiver operating characteristic curve of 0.750 (95%CI 0.743\u20130.757) and classified 27% as high risk and 73% as low risk. This risk stratification was significantly associated with adverse maternal and neonatal outcomes. Conclusion: The present study identified NICU admission risk factors for term neonates; along with the machine learning ranking of the risk factors, the highly predictive model may serve as a basis for individual risk calculation algorithm prior to delivery. We suggest that in the future, this type of planning of the delivery will serve different health systems, in both high- and low-resource environments, along with the NICU admission or transfer policy.<\/jats:p>","DOI":"10.3390\/jcm11154258","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T12:53:45Z","timestamp":1658494425000},"page":"4258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["NICU Admission for Term Neonates in a Large Single-Center Population: A Comprehensive Assessment of Risk Factors Using a Tandem Analysis Approach"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9721-2699","authenticated-orcid":false,"given":"Shahar","family":"Talisman","sequence":"first","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3458-7896","authenticated-orcid":false,"given":"Joshua","family":"Guedalia","sequence":"additional","affiliation":[{"name":"The Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan 5290002, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rivka","family":"Farkash","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tehila","family":"Avitan","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naama","family":"Srebnik","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2227-1074","authenticated-orcid":false,"given":"Yair","family":"Kasirer","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Pediatrics, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Schimmel","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Pediatrics, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunia","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Unger","sequence":"additional","affiliation":[{"name":"The Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan 5290002, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorina","family":"Grisaru Granovsky","sequence":"additional","affiliation":[{"name":"Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1001\/jamapediatrics.2018.3619","article-title":"Association of Nurse Workload with Missed Nursing Care in the Neonatal Intensive Care Unit","volume":"173","author":"Mara","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Tawfik, D.S., Thomas, E.J., Vogus, T.J., Liu, J.B., Sharek, P.J., Nisbet, C.C., Lee, H.C., Sexton, J.B., and Profit, J. 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