| Early discharge among late preterm and term newborns and risk of neonatal morbidity. | |
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MedLine Citation:
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PMID: 16731278 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Understanding how late preterm infants (34-36 completed weeks' gestation) are affected by discharge policies created for term infants (37-41 completed weeks' gestation) is essential for preventing postdischarge neonatal morbidity among late preterm infants. We analyzed linked birth certificate and hospital discharge data for Massachusetts between 1998 and 2002 to evaluate the risk of neonatal morbidity (defined as hospital readmission, observational stay, or both) between all vaginally delivered, live-born singleton late preterm and term infants. All infants were born at a Massachusetts hospital to a state resident and were discharged home early (<2-night hospital stay). We calculated crude and adjusted risk ratios using a modified Poisson regression and compared the timing and principal discharge diagnoses for those neonates who needed hospital readmission. Of the 1004 late preterm and 24,320 term infants in our study, 4.3% and 2.7% of infants, respectively, were either readmitted or had an observational stay. Late preterm infants were 1.5 times more likely to require hospital-related care and 1.8 times more likely to be readmitted than term infants. Among infants who were breastfed, late preterm infants were 1.8 times more likely than term infants to require hospital-related care and 2.2 times more likely to be readmitted. In contrast, no differences were found between late preterm and term infants who were not breastfed. Jaundice and infection accounted for the majority of readmissions. Our findings suggest that late preterm infants discharged early experience significantly more neonatal morbidity than term infants discharged early; however, this may be true only for breastfed infants. Evidence-based recommendations for appropriate discharge timing and postdischarge follow-up for these late preterm infants are needed to prevent neonatal morbidity. |
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Authors:
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Kay M Tomashek; Carrie K Shapiro-Mendoza; Judith Weiss; Milton Kotelchuck; Wanda Barfield; Stephen Evans; Angela Naninni; Eugene Declercq |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Seminars in perinatology Volume: 30 ISSN: 0146-0005 ISO Abbreviation: Semin. Perinatol. Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-05-29 Completed Date: 2006-10-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7801132 Medline TA: Semin Perinatol Country: United States |
Other Details:
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Languages: eng Pagination: 61-8 Citation Subset: IM |
Affiliation:
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Centers for Disease Control and Prevention, Division of Reproductive Health, Maternal and Infant Health Branch, Atlanta, GA 30341, USA. kct9@cdc.gov |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Birth Weight Breast Feeding / epidemiology Cohort Studies Educational Status Female Gestational Age Humans Infant, Newborn Infant, Newborn, Diseases / epidemiology Infant, Premature* Infant, Premature, Diseases / epidemiology Jaundice, Neonatal / epidemiology Male Massachusetts / epidemiology Middle Aged Nurseries, Hospital / utilization* Patient Discharge / statistics & numerical data* Patient Readmission / statistics & numerical data* Poisson Distribution Postnatal Care / statistics & numerical data* Pregnancy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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