Article

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

ABSTRACT

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.

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    • "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. "
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    • "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). "
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