Abstract
Background: Early postpartum discharge of newborns from hospital is an established routine. However, readmission is reported to occur in various degrees. Karolinska hospital is a III level hospital practicing early discharge, earliest 6 hours but within 72 hours postpartum. Scheduled check-up of the infants takes place at the follow-up clinic, mostly within 3–5 days after delivery and includes also metabolic screening and breast-feeding promotion.
Objective: To describe rates and causes of readmission for early-discharged infants.
Design: Retrospective study of a 18 months-period, Jan 2003 to June 2004 of all newborns born at Karolinska hospital, early discharged and who had to visit the emergency clinic during the first postnatal week.
Results: Total number of deliveries were 7379. 6990 of these were at term gestation (37 weeks). Our data refers to this group of infants. A total number of 5116 / 6990 (73%) infants of mothers with low-risk singleton births were discharged early, 65% within 48 hours. 98 / 5116 (2%) infants early discharged had to visit the paediatric emergency clinic. 69 (1.3%) of these were readmitted to hospital ward for observation / treatment; remaining recieved policlinical advice. Main causes for readmission were: 44 / 69 = jaundice requiring phototherapy and in three cases also exchange transfusion of which two were associated to ABO isoimmune disease, 10 / 69=feeding difficulties, 7 / 69 = respiratory symptoms, 6 / 69 = infection / suspect infection, 2 / 69 = parental anxiety. All infants had a healthy outcome except one who suffered severe brain damage due to an inborn error of metabolism.
Conclusions: We identified the importance of improving our routines connected to the discharge of ABO-incompatible newborns but also in giving parents accurate information on breast feeding and on the physiological changes of newborns (skin color, body weight, alertness). These new routines will be evauated during an oncoming 18 months-period.
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Fornell-Högberg, G., Kjellson, K., Baarman, I. et al. 128 Early Newborn Discharge Follow-Up. Pediatr Res 58, 376 (2005). https://doi.org/10.1203/00006450-200508000-00157
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DOI: https://doi.org/10.1203/00006450-200508000-00157
