Early discharge and readmission to hospital in the first month of life in the Northern Region of the UK during 1998: A case cohort study

Newcastle University, Newcastle-on-Tyne, England, United Kingdom
Archives of Disease in Childhood (Impact Factor: 2.9). 03/2005; 90(2):119-24. DOI: 10.1136/adc.2003.040766
Source: PubMed


To study the frequency and associations of early postpartum discharge and infant readmission to hospital.
Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region of the UK were studied.
A total of 4743 of 11,338 (42%) babies were discharged on or before the first postnatal day. Rates of early discharge varied significantly between hospitals. Infants <2500 g at birth (adjusted odds ratio (AOR) 0.44, 95% CI 0.29 to 0.66), infants 35-37 weeks gestation at birth (AOR 0.65, 95% CI 0.49 to 0.86), and firstborn infants (AOR 0.09, 95% CI 0.08 to 0.10) were less likely to be discharged early. Women from more deprived areas were more likely to be discharged early (AOR 1.37, 95% CI 1.12 to 1.67). A total of 907 of 32,015 (2.8%) babies liveborn in the region were readmitted to hospital during 1998. Readmission rates varied significantly by hospital of birth but not by timing of discharge. Babies <2500 g at birth (AOR 1.95, 95% CI 1.16 to 3.28) and babies born at 35-37 weeks gestation (AOR 1.72, 95% CI 1.15 to 2.57) were more likely to be readmitted. Breast fed babies were less likely to be readmitted (AOR 0.69, 95% CI 0.53 to 0.90). Infants initially discharged early were not more likely to be readmitted.
Early discharge occurred variably in the Northern Region in 1998. It is not associated with readmission to hospital. Breast feeding is associated with lower rates of readmission to hospital.

Download full-text


Available from: Sam Oddie
    • "The most plausible causal explanation for this is that neonatal illness has a detrimental effect of on auditory neurodevelopment; the association between time in the Neonatal Intensive Care Unit (NICU) and hearing loss is wellestablished (Davis et al, 1997), although in this study we did not find a higher risk of hyperacusis in babies admitted to NICU at birth but rather in those still in hospital at four weeks or who had been readmitted. Readmission to hospital after discharge may be due to suspected infection, feeding problems, life threatening events, or jaundice, although in many cases there is no clear organic diagnosis (Oddie et al, 2005). Alternatively, it is possible that adverse experiences in the neonatal period might cause changes in cognitive development and predispose the child to later behavioural or emotional problems (Anand &amp; Scalzo, 2000) which might contribute to any hyperacusis or phonophobia. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To estimate the prevalence of reduced sound tolerance (hyperacusis) in a UK population of 11-year-old children and examine the association of early life and auditory risk factors with report of hyperacusis. Design: A prospective UK population-based study. Study sample: A total of 7097 eleven-year-old children within the Avon longitudinal study of parents and children (ALSPAC) were asked about sound tolerance; hearing and middle-ear function was measured using audiometry, otoacoustic emissions, and tympanometry. Information on neonatal risk factors and socioeconomic factors were obtained through parental questionnaires. Results: 3.7% (95% CI 3.25, 4.14) children reported hyperacusis. Hyperacusis report was less likely in females (adj OR 0.64, 95% CI 0.49, 0.85), and was more likely with higher maternal education level (adj OR 1.72, 95% CI 1.08, 2.72) and with readmission to hospital in first four weeks (adj OR 1.98, 95% CI 1.20, 3.25). Report of hyperacusis was associated with larger amplitude otoacoustic emissions but with no other auditory factors. Conclusions: The prevalence of hyperacusis in the population of 11-year-old UK children is estimated to be 3.7%. It is more common in boys.
    No preview · Article · Dec 2015 · International journal of audiology
  • Source
    • "This seems hopeful, but is it only due to a natural adaptation during the years or also the result of increased awareness leading to improved follow-up and medical guidance? These are questions that remain to be answered, although various reports do suggest a protective effect of specific follow-up programs [3] [25]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: There is a gap in the knowledge of longterm outcome of mild to moderate prematures compared to the extreme prematures or very low birth weight infants. Determine health-related quality of life (HRQoL) and prevalence of emotional and behavioral problems in (pre-)school age children born at 32 to 36 weeks' gestation. A descriptive cohort study in a non-Neonatal Intensive Care Unit. Patient characteristics, diagnoses, treatment and social economic status (SES) were analyzed. Study tools were the TNO-AZL Preschool Quality of Life (TAPQoL) and Child Behavior Checklist (CBCL). 362 children born between 32 and 36 weeks' gestation who had a follow-up evaluation at 2-5 years of age. Health-related quality of life and the occurrence of emotional and behavioral problems. Main characteristics (mean±SD) were: gestation 34.7±1 weeks and birth weight 2360±444 g. Most families were two-parent middle-class households with parents employed at their educational level. Questionnaire response rate was 62.7%. The 12-item TAPQoL showed significantly lower scores for stomach and liveliness, while scores for behavior, communication and sleep were significantly higher compared to the general population. The TAPQoL subscale score for lung problems was significantly lower for children who had received continuous positive airway pressure (CPAP). CBCL scores were within the validated normal range although the study-population scored higher on emotionally reactive, somatic complaints and attention problems compared to their full-term peers. Children born at 32 to 36 weeks' gestational age do not experience an overall lower HR-QoL at 2 to 5 years of age. CPAP results in lower HRQoL scores for lung problems. The overall occurrence of behavioral and emotional problems does not differ from the general term-born pediatric population. Several subitems need further attention.
    Full-text · Article · Jun 2011 · Early human development
  • Source
    • "In the UK, investigations on the connection between early discharge and re-hospitalization within the first month reveal that 2.8% of new-borns are re-hospitalized due to infections, ‘colic' feeding problems, and jaundice. The authors conclude re-hospitalization is not dependent on the time of leaving hospital and that breast-fed children are at lower risk of re-hospitalization (12). In Sweden, the risk of re-hospitalization was similar when comparing those cared for in the maternity ward and those who were discharged early, 1.7% (13). "
    [Show abstract] [Hide abstract]
    ABSTRACT: To gain a deeper understanding of first-time parents' experiences of early discharge from hospital after delivery and home-based postnatal care. The study was comprised of focus group interviews, interviews with couples and with fathers. Twenty-one parents participated. Inclusion criteria: healthy women who have given birth to their first child after a normal pregnancy and delivery, the women's partners, healthy and full term babies, Swedish-speaking, discharge from the delivery ward within 24 hours, resident in the Uppsala community, the parents cohabited at the time of the delivery. The material was analysed by qualitative content analysis. Three themes emerged: The family's strategy, which describes the family's expectations of postnatal care and their experiences of the real situation. Some are flexible concerning going home early, and others have decided in advance. Self-reliance and strength, which explores the parents' feelings of security and uncertainty, freedom and independence, and shared responsibility. Breast-feeding is described as the 'main thing', an interactive learning process. Professional support in the home summarizes the parents' experience of the midwife's support at home. While conflicting feelings may be revealed during the first days, the midwife confirms their new roles as parents. The midwife is seen as a support and adviser to the parents. This study shows that parents welcome home-based postnatal care with professional support from midwives. We conclude that this care suits healthy families. We think it will be more important in the future to discriminate between healthy families and those in need of hospital care, than to focus on the moment when they leave the hospital, early or late.
    Full-text · Article · May 2010 · Upsala journal of medical sciences
Show more