Document Detail


Early discharge among late preterm and term newborns and risk of neonatal morbidity.
MedLine Citation:
PMID:  16731278     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in perinatology     Volume:  30     ISSN:  0146-0005     ISO Abbreviation:  Semin. Perinatol.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2006-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7801132     Medline TA:  Semin Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  61-8     Citation Subset:  IM    
Affiliation:
Centers for Disease Control and Prevention, Division of Reproductive Health, Maternal and Infant Health Branch, Atlanta, GA 30341, USA. kct9@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
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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