Article Text

  1. ML Kumm1,
  2. L Veeber1,
  3. V Duškevits1,
  4. K Kovaljova1,
  5. M Laan1,
  6. P Andresson2,
  7. L Toome1
  1. 1Department of Paediatrics, Tallinn Childreńs Hospital, Tallinn, Estonia
  2. 2Department of Neonatology, Womeńs Clinic, East Tallinn Central Hospital, Tallinn, Estonia


Objective Arrangement of neonatal medical care in Estonia has changed over the past 15 years: newborns are discharged earlier from the maternity hospitals and followed up by family doctors. This study was undertaken to analyze the reasons for readmissions during the neonatal period.

Methods Retrospective analysis of hospital charts of newborns readmitted during neonatal period to Tallinn Childreńs Hospital in 2005–2006.

Results During the defined period of time 10,071 live newborns were registered in Tallinn, 360 (3.6%) of them were readmitted. 81 (23%) of them on their first, 109 (30%) on their second, 89 (25%) on their third and 81 (22%) on their fourth week of life. 64 (18%) newborns were sent to hospital by family doctors, 68 (19%) by ambulance and 116 (32%) by different specialists. 112 (31%) babies were brought to emergency room by parents. 104 (29%) children were readmitted due to infections, 64 (18%) neonatal jaundice, 57 (16%) feeding difficulties, 27 (7%) malformations, 14 (4%) neurological pathology, 6 (2%) injury, 88 (24%) with different problems. 89% of newborns with neonatal jaundice and 68% with feeding difficulties were hospitalized during their first two weeks of life. 49 babies had their total bilirubin value over 310 μmol/l, in one case only hypernatremic dehydration was diagnosed. 70% of mothers of children with feeding difficulties were primiparous. Bacterial infection was diagnosed in 54% of children with infectious pathology.

Conclusions Rearrangements in the neonatal medical care in Estonia are safe if primiparous mothers are effectively counselled about breastfeeding and child care. Active follow-up by different specialists may reduce the risk of readmission.

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