Characteristics of non-urgent neonatal presentations to an Australian metropolitan emergency department

Aim: To determine characteristics and risk factors for non-urgent presentations (NUPs) (triage categories 4 and 5) in neonates to a Western Sydney metropolitan mixed adult emergency department (ED) and the effect of COVID-19 on presentations and admissions. Methods: A retrospective medical record study examined neonates (age <4 weeks) presenting to the ED between October 2019 and September 2020 and assessed risk factors for NUPs including the impact of COVID-19. Regression analysis was used to determine which risk factors were significant for NUPs to ED and whether there were any significant differences in urgency of presentations and admissions during the post-COVID-19 time (on/after 11th March 2020). Results: From 277 presentations, 114 (41%) were non-urgent. After regression analysis, being a mother born overseas (odds ratio 2.15, 95% confidence interval 1.13-4.12, P = 0.02) was a significant risk factor and maternal age (odds ratio 0.98, 95% confidence interval 0.96-0.1.00, P = 0.02) was a significant protective factor for NUPs in the neonatal period. There were 54 (47%) NUPs pre-COVID-19 and 60 (53%) NUPs post-COVID (P = 0.70). There were similar presenting complaints and diagnoses compared to the literature. Conclusions: Mothers born overseas and younger maternal age were found to be significant risk factors for NUPs in the neonatal period. There was no apparent impact on presentations and admissions to ED during the COVID-19 period. Further studies are warranted to further evaluate risk factors for NUPs in the neonatal period and further elucidate the impact of COVID-19 on presentations and admissions, specifically in later waves of the virus.