Impact of early discharge from the maternity ward on the risk of neonatal rehospitalization: A case-control study.

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie Pub Date : 2024-11-20 DOI:10.1016/j.arcped.2024.09.003

Cassandra Varoqui, Abdou Yacoubou Omorou, Laurélia Jourdan, Jean-Michel Hascoet

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引用次数: 0

Abstract

Background: The time for newborn discharge from the maternity ward has been shortened in recent decades with consequences that are still debated.

Objectives: The primary objective of this study was to establish whether early discharge could be a risk factor for rehospitalization in the neonatal period. Second, we aimed to study the incidence of neonatal hospitalizations and their causes. Next, we tried to determine other possible risk factors for rehospitalization after discharge.

Methods and setting: This is a retrospective, single-center, case-control study collecting data on newborns rehospitalized in the first 28 days of life at Nancy University Hospital, after their discharge from the maternity ward. These newborns were born between 01/06/2021 and 31/05/2022 and were matched with two healthy infants who did not require rehospitalization according to term and month of birth. A logistic regression model was used to evaluate the association between early discharge and risk of hospitalization.

Results: 2,054 healthy full-term babies were born during the study period; 108 (5%) were rehospitalized and compared to 219 randomly selected newborns who did not required hospitalization. Among the 108 cases included, 42 (38.9%) obtained early discharge versus 91 out of 219 (41.6%) controls. Multivariate logistic regression showed no significant association between early discharge and risk of hospitalization (ORa=1.1 [95%CI: 0.7 to 1.8], p = 0.69). However, phototherapy treatment during the maternity ward stay was a significant risk factor for rehospitalization (ORa=5.O [2.5 to 9.9], p < 0.0001). The main causes of hospitalization were jaundice and respiratory infections.

Conclusion: Early discharge from the maternity ward does not constitute a risk factor for readmission in the neonatal period in this study. Changes in perinatal practices, such as ambulatory delivery and very early discharge, should be included in revised recommendations.

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产房提前出院对新生儿再次住院风险的影响：病例对照研究。

背景：近几十年来，新生儿离开产科病房的时间不断缩短，但其后果仍存在争议：本研究的主要目的是确定提前出院是否会成为新生儿期再次住院的风险因素。其次，我们旨在研究新生儿住院的发生率及其原因。其次，我们试图确定出院后再次住院的其他可能风险因素：这是一项回顾性、单中心、病例对照研究，收集了南锡大学医院新生儿出院后 28 天内再次住院的数据。这些新生儿出生日期在 2021 年 6 月 1 日至 2022 年 5 月 31 日之间，并与两名无需再次住院的健康婴儿按出生月份和足月进行了配对。结果：研究期间共出生了 2,054 名健康足月婴儿，其中 108 名（5%）再次住院，并与随机抽取的 219 名无需住院的新生儿进行了比较。在 108 例病例中，有 42 例（38.9%）提前出院，而在 219 例对照中，有 91 例（41.6%）提前出院。多变量逻辑回归显示，提前出院与住院风险之间无明显关联（ORa=1.1 [95%CI: 0.7 to 1.8]，p = 0.69）。然而，产科病房住院期间的光疗是再次住院的一个重要风险因素（ORa=5.O [2.5 至 9.9]，P < 0.0001）。住院的主要原因是黄疸和呼吸道感染：结论：在本研究中，产科病房提前出院并不构成新生儿期再次入院的风险因素。围产期做法的改变，如非卧床分娩和过早出院，应纳入修订后的建议中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.