Neonatal Intensive Care Unit Resource Use for Infants at 22 Weeks' Gestation in the US, 2008-2021

Question How has resource use in US neonatal intensive care units (NICUs) changed in light of updated clinical guidance about intensive care for infants born at 22 weeks' gestation? Findings In this serial cross-sectional study of 825 112 infants admitted to 137 NICUs in 29 US states from 2008 to 2021, there was a 388% increase in NICU admissions, 732% increase in bed-days, and 946% increase in ventilator-days for 22-week infants compared with other extremely preterm infants. Increases in resource use also occurred for infants born at less than 22 and at 23 weeks. Meaning These findings suggest that an increasing share of resources in US NICUs is allocated to infants born at 22 weeks' gestation.