A. K. Brown, K. Damus, M. H. Kim, K. King, R. Harper, D. Campbell, K. A. Crowley, M. Lakhani, N. Cohen-Addad, R. Kim, A. Harin
Factors relating to readmission of term and near term neonates in the first two weeks of life
Aims: A multisite study of term and near term infants
readmitted in the first two weeks of life to 9 New York
City area hospitals in 1995 was conducted to evaluate
factors related to readmission, including length of newborn
stay.
Results: Of the 30,884 infants born at the 9 study hospitals
391 newborns were readmitted. The major admission
diagnoses were infection, 40.7 %, hyperbilirubinemia,
39.1 %, and feeding and/or gastrointestinal problems,
10.5 %. In the first week, 65.1% of readmissions
were for hyperbilirubinemia and 19.1% were for infection
or suspected sepsis. In the second week, 67.8%
of readmissions were for infection and 7.6% were for
hyperbilirubinemia. Hyperbilirubinemia was the most frequent diagnosis for White and Asian infants, while
infection was most frequent for African-American and
Hispanic infants. Age at readmission was younger and
the interval from discharge was shorter for infants with
hyperbilirubinemia. Abnormalities which should have
precluded early discharge included feeding difficulties,
cyanotic congenital heart defects, hemolytic disease of
the newborn, early jaundice or early high bilirubin
levels.
Conclusion: Attention to identification of infants at risk
and programs such as lactation counseling and universal
screening for bilirubin (with appropriate interpretation)
prior to discharge could have reduced the necessity for
readmission regardless of the newborn length of stay.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 27, 09/1999
Pages: 263 - 275
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