More babies are being admitted to NICUs in Indiana: CDC data brief

More babies are being admitted to neonatal intensive care units, or NICUs, across the country, according to a data brief from the Centers for Disease Control and Prevention. The brief analyzed NICU admissions data between 2016 and 2023.

Infants may be admitted to the NICU for a variety of reasons, including being born early, underweight, having birth defects, infections or heart or respiratory issues.

The report found that about 1 in 10 infants nationwide were admitted to a NICU in 2023, which marks a 13% increase from 2016.

Many Midwest states saw increases in the rate of babies being admitted to NICUs during that time period.

In 2023, the percentage of babies admitted to the NICU was 11.4% in Indiana, 10.1% in Illinois, 10.7% in Iowa, 8.5% in Kansas, 11.3% in Kentucky, 10.5% in Missouri, 11.4% in Nebraska, 10.2% in Ohio, and 8.9% in Oklahoma.

Dr. Laura Haneline, division chief of neonatology at Indiana University School of Medicine who was not involved in the CDC data brief, said many of the factors that put infants at risk happen before mothers even get pregnant.

"Here in Indiana, our whole population has a higher risk of diabetes, [being] overweight, living in communities that may have less access to healthy food options," she said, adding that socioeconomic factors and limited access to obstetric care can also contribute to poorer outcomes.

While medical advancements in NICUs have allowed the health care system to support infants at earlier gestational ages, Haneline said that doesn't account for the increases NICU admissions.

Another factor is the closures of labor and delivery units in rural locations across the country, which leads some pregnant women to have to travel longer to receive care. This can increase the risk of complications and death for both mothers and infants.

Over 100 rural hospitals have stopped delivering babies since 2020, or have announced they will stop during 2025, according to a report from the Center for Healthcare Quality and Payment Reform. States like Indiana led the pack with a reported 12 rural labor and delivery units closing since 2020.

Haneline also worries about proposed cuts to Medicaid at the federal level because the public health insurance program covers many of the NICU admissions and the care for babies born with complex medical problems as well as uninsured women who are pregnant, she said.

Recent decisions by Indiana's state legislature to reduce funding for local public health departments could also undercut efforts to reduce infant mortality in the state, she said.
 

The admission rates nationwide increased across all maternal age and racial groups, but some subsets saw larger increases than others.

NICU admissions for babies born to mothers who are between 20 and 29 years of age rose 11%, while the 30-39 age group saw the largest increase of 12%. Infants born to mothers aged 40 and older were the most likely to be admitted in 2016 and 2023, but that age group only saw an increase of 9%.

All racial groups saw an increase in NICU admissions but the greatest increases were among infants born to Whites, Blacks, American Indians, and Native Hawaiian and Pacific Islanders.

The disparities dovetail with another trend captured in a recent Harvard study, which found that the gap in infant mortality rates between White Americans and Black Americans has grown since the 1950s. That's despite the fact that the gap between overall mortality of the two groups has been narrowing, said Soroush Saghafian, one of the study authors and an associate professor of public policy at the Harvard Kennedy School.

"We are seeing that now it's worse than what it was in [the] 1950s and this is concerning, obviously, for multiple reasons," he said.

Infant mortality rates have fallen overall for both White and Black children. In the 1950s, Saghafian found roughly 2,703 infant deaths per 100,000 persons among White infants and 5,181 among Black infants. In the 2010s, deaths among White infants had fallen to 499 per 100,000 but only to 1,073 for Black infants.

Saghafian cautions that more research is needed to better understand why the gap is growing, but he has some theories.

"Health care has improved for both White and Black people," Saghafian said. "But it has improved for White people much faster and much more than it has improved for the Black and that causes sort of the increase in the gap that we are seeing."

Contact WFYI and Side Effects Public Media's Health Reporter Benjamin Thorp at bthorp@wfyi.org.

Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.