Neonatal hospital readmissions: Rate and associated causes

Background: The neonatal period is important for establishing a strong healthy foundation and is also associated with high mortality and morbidity rates. This study aimed to determine the rate of neonatal hospital readmission and to identify the associations between the neonatal age at readmission and the length of stay (LOS) during readmission, the outcome of readmission, and the associated maternal and neonatal factors. Methods: A cross-sectional study was performed by reviewing the medical records of 570 neonates who were born in and readmitted to King Abdulaziz Medical City, Riyadh, Saudi Arabia, through emergency and outpatient clinics from January 2016 to December 2018. Results: The neonatal readmission rate during the study period was 2.11%. The most common causes for readmission were respiratory diseases (24.9%), jaundice (22.1%), and fever to rule out sepsis (16.7%). Sex and breastfeeding were significantly associated with neonatal age at readmission (P = 0.025 and P = 0.017, respectively), but only breastfeeding was a significant predictor of age at readmission. Males were more likely to be admitted at the age >7 days, and exclusively formula-fed neonates were approximately three times the risk compared to exclusively breastfed neonates to be admitted at age >7 days (adjusted risk ratio 2.9, 95% confidence interval). Neonates readmitted at ages >7 days had double the LOS as those readmitted at ages ≤7 days (P < 0.001). The outcomes (discharge or pediatric intensive care unit admission) had no significant association with neonatal age at readmission. Conclusion: The readmission rate was 2.11% and was most commonly due to respiratory diseases. Age at readmission was significantly associated with sex, breastfeeding, and LOS. Assessment of the factors associated with readmission before discharge may reduce the rate of readmission.