FLORENCE, S.C. (WBTW) – The percent of newborns who end up in neonatal intensive care units in South Carolina has nearly doubled since 2004, according to a data analysis by News13.

In some counties, like Marlboro, that rate has close to tripled.

In 2004, 58.5 babies per 1,000 born statewide – or 5.9% – ended up in a NICU. By 2020, that had reached 94.5 babies per 1,000 born, or 9.4%, totaling 5,264 babies. 

The South Carolina Department of Health and Environmental Control began tracking the statistic in 2004. Since then, Marlboro County’s rate has gone from 51.1 per 1,000 babies born ended up in NICUs, to 135.5 in 2020.

Dillon County’s rate has about doubled to reach 6.8% of babies born being admitted to NICUs, and Horry County’s rate has doubled to 7.2%.

In 2004, no counties had more than 10% of newborns admitted to a NICU. In 2020, 18 of the state’s 46 counties had rates above 10%.

2020’s highest rate was in Abbeville County, where 17% of babies born were admitted to a NICU.

The higher rates are due to a combination of factors, mostly due to patient and maternal health, according to Dr. Douglas Moeckel, the medical director of the NICU at McLeod Health in Florence. He’s seen an increase in maternal complications, including drug abuse and both chronic and pregnancy-induced hypertension.

“We see a lot of obesity, and subsequently, Type 2 diabetes,” he said.

Those factors contribute to an unhealthy prenatal environment. However, he said, some NICU admissions can’t be prevented.

“A lot of times it’s just bad luck that a mom delivers prematurely,” he said.  

The hospital had a 28-bed NICU when he started there in 2013. Last summer, that expanded into a 48-bed, private room NICU.

He said that babies born before 35 weeks gestation are automatically admitted to the NICU, along with small babies, or ones who are growth restricted.

NICU babies receive a higher level of care. Extremely preterm babies can face complications, and may need to rely on donated human breast milk.

Moeckel said NICU rates might also be linked to access to prenatal care.

The March of Dimes has identified eight of the state’s 46 counties as maternity care deserts, according to a 2021 report. Another 13 are rated as having low access to maternity care.

The organization’s report card gives South Carolina an “F” grade for its preterm birth rate, which rests at 11.8%. Horry, Charleston and Richmond counties were individually given “F” grades for their preterm birth rates.

Since 2004, DHEC statistics don’t show much difference in preterm birth rates, or in the rate of mothers seeking prenatal care.

Neonatology has also evolved during that time frame, giving young and sick babies a better chance of leaving hospitals and leading healthy lives. 

Those advances include artificial surfactant, which help babies breathe easier, Moeckel said. There has also been ongoing work on how premature babies are ventilated, and new high-frequency ventilators that are leading to better outcomes.

Living a lifestyle that includes a healthy diet and exercise, he said, can be preventative measures, which he recommends for anyone of childbearing age who plan to become pregnant or have a chance to.

Use the searchable database below to track how NICU rates have changed since 2004.