Factors Affecting Neonatal Intensive Care Unit Length of Stay in Preterm Infants Receiving Dysphagia Rehabilitation Therapy: A Retrospective Study

Objective: Neonatal dysphagia is a frequent barrier to discharge in preterm and medically complex infants.This study sought to identify independent predictors of neonatal intensive care unit (NICU) length of stay (LOS), with particular focus on the timing of dysphagia rehabilitation therapy as a potentially modifiable factor.Methods: We retrospectively reviewed 339 preterm infants (<37 weeks gestation) who received dysphagia rehabilitation therapy in a tertiary-level NICU at our institution between January 2015 and December 2024.Infants with major congenital anomalies, in-hospital mortality, or inter-hospital transfers were excluded.Variables significant in univariate analyses were entered into a multivariate linear regression model to determine independent associations with LOS. Results:The cohort had a mean gestational age of 33.42.7 weeks and mean birthweight of 1,938 614 g.Dysphagia therapy began at a median postnatal age of 13 days (interquartile range, 5.5-21.0).Mean NICU LOS was 28.825.1 days.In the multivariate model, four factors independently predicted longer LOS: later initiation of therapy (=0.39;95% confidence interval, 0.24-0.54;P<0.001), lower birthweight (=-0.02,P<0.001), respiratory distress syndrome (=6.99,P=0.001), and bronchopulmonary dysplasia (=30.12,P<0.001).Each additional week of delay in therapy initiation was associated with approximately 2.7 more hospitalization days.Conclusion: While birthweight and pulmonary morbidities are largely nonmodifiable, earlier initiation of dysphagia rehabilitation-once the infant is medically stable-emerges as a practical intervention that may shorten NICU LOS and improve bed utilization.