On April 2, 2008, UC San Diego Medical Center-Hillcrest celebrated the opening of an expanded Neonatal Intensive Care Unit (NICU) designed for the 24-hour specialized care of premature infants and newborns with complications.
Nine licensed beds have been added to the existing 40-bed unit to increase the number of infants who can receive Level III neonatal intensive care from 780 newborns per year to more than 900. The $2.6 million dollar project is the first of a series of initiatives to expand and improve women's and infant's services at UC San Diego Medical Center.
“One in eight babies across the U.S. is born prematurely. Here in San Diego we have seen a sustained increase in the number infants needing intensive care for more than five years now,” said Neil Finer, M.D., director of the Division of Neonatology at UCSD Medical Center. “By expanding our services, we can treat more of these fragile infants to help ensure healthy outcomes.”
Every year, more than 3,000 babies are born at UCSD Medical Center-Hillcrest, the only academic medical center in San Diego, and the only hospital with the combination of a regional Level III NICU and a labor and delivery service on the same floor. The Level III designation is given by California Children's Services to hospitals that have the equipment and staff to handle very complicated births. Level III hospitals care for babies who are delivered before 32 weeks gestation, or who have serious illnesses or abnormalities requiring intensive care before, during, or after delivery.
Of the 780 infants cared for in the NICU each year, more than 90% are born at UCSD Medical Center, a regional center of excellence for high risk pregnancies. Because of its expertise in fetal care, genetics, minimally invasive in-utero fetal surgery, and radiology, families with complicated births are referred to UCSD Medical Center and arrive from throughout the region including Imperial County, Riverside, Los Angeles, San Bernardino, Orange County, and beyond.
The new 1,795 square-foot unit facility was designed by Childs Mascari Warner Architects and built by Turner Construction. The space blends a bright family-centered atmosphere with the most current newborn technology available. Families may personalize their space and rest by their infant's bedside. A ‘Parent Resource Room' offers internet access and educational materials. Each of the nine private patient areas can accommodate one critical infant, or be used by up to three less acute babies, allowing for the co-bedding of multiples.
About UCSD's Infants
“Small babies born under 28 weeks may be with us for up to three months. Those with multisystem problems may be here as long as 6 months. The smaller the baby, the longer the time they and their families will be in the unit,” said Finer. “The expanded NICU will be used primarily for premature babies who are stabilized beyond their acute needs but still require specialized feeding care and nutrition.”
Babies born at less than 25 weeks gestation, sometimes weighing less than 16 ounces, require intensive respiratory, pulmonary and nutritional care. Minute to minute attention is required to prevent neurological damage and possible malnutrition in infants whose internal organs have not yet fully developed.
“In the seventies, a premature baby weighing less than 3 pounds had a 50% chance of surviving,” said Jan Hebert, R.N., nurse manager for the NICU. “The application of new research findings and current technology has changed the picture dramatically. Today, the survival rates of these infants are 90% or better.”
Premature Birth: A National Trend
The U.S. has one of the highest pre-term birth rates in the world with 12% of babies being born before 37 weeks gestation, according to the Centers for Disease Control. According to the March of Dimes, premature births have been escalating steadily over the past two decades. In 2005, more than 525,000 infants were born prematurely, the highest number ever reported for the U.S. The rate of premature birth increased almost 35 percent between 1981 and 2005 (9.4 to 12.7 percent).
Thomas Moore, M.D., professor and chairman of the Department of Reproductive Medicine at UC San Diego Medical Center cites advanced artificial reproductive technologies and shifts in maternal age as reasons for the increasing numbers of premature and multiples births in the region.
“The reason that the birth rate in the U.S. is generally flat but NICU admissions are rising is the advancing age of mothers at delivery and increasing use of artificial reproductive technologies which produce multiple fetuses,” said Moore. “While new technologies have brought fertility to thousands of families who otherwise would not have their own children, the proportion of premature infants has risen to 12% of all births, largely due to multiple gestations of twins, triplets and more.”
Moore also points to the nationwide epidemic of obesity as a significant risk factor for newborns who need complex intensive care.
“We are also seeing an epidemic of maternal obesity and gestational diabetes,” noted Moore. “Babies of mothers with gestational diabetes are several fold more likely at birth to have respiratory problems, blood glucose regulation problems, and bilirubin issues, all of which requires NICU management, even if only for 1-3 days.”