Hidden morbidity with "successful" early discharge

J Perinatol. 2002 Jan;22(1):15-20. doi: 10.1038/sj.jp.7210586.

Abstract

Objective: This study was conducted to determine if early postnatal discharge (EDC; < or =48 hours) in well newborns had an effect on the rate of hospital readmission within the first week after hospital discharge when compared to infants who remained >48 hours after birth (later discharge, LDC).

Study design: This was a retrospective medical chart review. Charts of infants born between January 1994 and December 1998, discharged as "well newborns" and treated subsequently at a primary children's hospital within 7 days of neonatal discharge, were reviewed. Infants were categorized by length of neonatal hospital stay, level of medical intervention (emergency department treatment or hospital admission), and final diagnosis.

Results: There was a significant increase in hospital readmission rate for LDC infants when compared to EDC infants. When considering jaundice alone as an admitting diagnosis, EDC infants were admitted at a higher rate than LDC infants and with higher serum bilirubin concentrations. Readmitted, jaundiced infants had been almost always breast-fed.

Conclusion: Overall, EDC of well newborns appears to be a safe and reasonable practice. However, the risk for severe jaundice is an unresolved issue that requires a discharge strategy and early follow-up to prevent serious morbidity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding
  • Humans
  • Infant, Newborn
  • Jaundice, Neonatal / diagnosis
  • Jaundice, Neonatal / epidemiology
  • Kentucky / epidemiology
  • Length of Stay*
  • Maternal Health Services / standards
  • Patient Readmission / statistics & numerical data*
  • Postnatal Care / standards*
  • Retrospective Studies