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A validated NICU database: recounting 50 years of clinical growth, quality improvement and research

Pediatric Research volume 97, pages 2224–2234 (2025)Cite this article

Abstract

The importance of a Neonatal Intensive Care Unit (NICU) database lies in its critical role in improving the quality of care for very preterm neonates and other high-risk newborns. These databases contain extensive information regarding maternal exposures, pregnancy complications, and neonatal care. They support quality improvement (QI) initiatives, facilitate clinical research, and track health outcomes in order to identify best practices and improve clinical guidelines. The Parkland Memorial Hospital NICU database was originally part of the Maternal and Neonatal Data Acquisition, Transmission and Evaluation project funded by the Robert Wood Johnson Foundation to assess perinatal-neonatal care in Dallas County Texas, 1977–1982. Clinical data points were defined, transcribed and validated in 1977; revalidation has occurred multiple times. Data are prospectively extracted from health records of high-risk neonates among >11,000 births annually. The database contains clinical information on >50,000 neonates, including all initially admitted to the NICU regardless of gestational age or birthweight and since 10/03/2011, all neonates admitted for observation and transferred to the term newborn nursery. The database has provided the basis for QI studies and research designed to assess and improve neonatal care. We discuss the history, evolution, administration, impact on neonatal outcomes, and future directions of our database.

Impact

  • A single neonatal intensive care unit (NICU) database was designed for prospective data collection, validated and maintained for 46yrs.

  • This database has supported quality improvement assessment, original clinical research, education and administrative requirements and impacted clinical neonatal care.

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Fig. 1: Timeline of development of Parkland NICU Database from 1977 to 2021.
Fig. 2: Infant survival and survival without severe morbidity by gestational age, January 2018-June 2023.
Fig. 3: Trends in treatment modalities for patent ductus arteriosus from 2001 to 2023 among neonates 24–28 weeks gestational age.

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Data availability

The datasets analyzed during the current study and the documentation notebook can be made available upon reasonable request after noting their intended use and after consideration by the Faculty physician responsible for its maintenance, currently Dr. Mambarambath Jaleel (email: Mambarambath.Jaleel@utsouthwestern.edu)

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Acknowledgements

The PMH NICU database program was initially written as part of the MANDATE project. It was later converted into successive versions of Access by Ms. Mechelle Murray and by Ms. Ellen Suen. The initiation and design of the database included Jon E Tyson, MD, Juan Jimeniz, MD, Charles R Rosenfeld, MD and Sue Mize, Director of Statistics at UTSW. Research nurses entering data in the NICU database have included Sherry Hutton, RN, Sharon Dowling, RN, Norma Threlkeld, RN, PNP and Patti Jeannette Burchfield, RN (2000–present). NICU database managers have included Jon E. Tyson, MD, Kathleen Kennedy, MD, Charles R. Rosenfeld, MD, Jeffrey Perlman, MD, Walid Salhab, MD (1998–2006), Luc P Brion, MD (2007–2023) and Mambarambath Jaleel, MD (2023–present). Kara Goss, MD, is the principal investigator of the Parkland Outcomes after Prematurity Study (POPS).

Author information

Authors and Affiliations

  1. Division of Neonatal–Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Kikelomo Babata, Charles R. Rosenfeld, Mambarambath Jaleel, Patti J. Burchfield, Marina Santos Oren, Lina Chalak & Luc P. Brion

  2. University of Texas Southwestern Medical School, Dallas, TX, USA

    Riya Albert

  3. Parkland Health and Hospital System, Dallas, TX, USA

    L. Steven Brown

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  1. Kikelomo Babata
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  4. Patti J. Burchfield
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  5. Marina Santos Oren
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  6. Riya Albert
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  7. L. Steven Brown
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  8. Lina Chalak
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  9. Luc P. Brion
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Contributions

Dr. Kikelomo Babata conceptualized and designed the study, designed the data collection instruments, searched for and retrieved relevant publications, collected data for validation and helped with first drafting of the manuscript. Dr. Charles R. Rosenfeld participated in the initial database design and contributed to the conceptualization and design of the study and assisted in the initial draft of the manuscript. Dr. Mambarambath Jaleel contributed to the conceptualization and the study design. Dr. Marina Santos Oren designed the data collection instruments and collected data for validation. Ms. Riya Albert designed the data collection instruments and collected data for validation. Ms. Patti J. Burchfield was responsible for collecting and entering all data for the database in 2000–2023 and assisted in the design of data collection instruments. Mr. L. Steven Brown designed the data collection instruments, did the randomization and carried out statistical analyzes. Dr. Chalak contributed by revising the manuscript critically for important intellectual content, including editing, formatting, and finalizing the document. Dr. Luc P. Brion conceptualized and designed the study, designed the data collection instruments, formulated data for validation, carried out statistical analyzes, searched for and retrieved relevant publications and drafted the first version of the manuscript. All authors critically have reviewed and edited the final manuscript, and all have approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

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Correspondence to Kikelomo Babata.

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Babata, K., Rosenfeld, C.R., Jaleel, M. et al. A validated NICU database: recounting 50 years of clinical growth, quality improvement and research. Pediatr Res 97, 2224–2234 (2025). https://doi.org/10.1038/s41390-024-03624-3

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