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Implementation of the AAP discharge guidelines reduces unplanned readmissions of newborn infants: a single-center study

Journal of Perinatology volume 46, pages 454–459 (2026)Cite this article

Subjects

Abstract

Objective

To evaluate the effectiveness of implementing American Academy of Pediatrics (AAP) discharge guidelines in reducing unplanned hospital readmissions within 30 days post-discharge among term ansd late preterm newborns.

Study design

Retrospective observational study analyzing unplanned readmissions at a single-center neonatal unit from January 1, 2021, to December 31, 2024. Data were compared before (January 1, 2021–June 30, 2022) and after (July 1, 2022–December 31, 2024) guideline implementation, with subgroup analysis for the period after addition of structured support (July 1, 2023–December 31, 2024).

Result

AAP guideline implementation was associated with a statistically significant reduction in unplanned readmission rates among term infants (0.66% vs. 0.33%; P = 0.008). No reduction was evident among late preterm infants. Subgroup analysis showed further reductions post-structured support addition, though confounding by provider changes limits attribution.

Conclusion

The adoption of the AAP discharge guidelines, along with a structured process of mother and infant readiness, significantly decreassed unplanned readmission rates among term newborns.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the neonatologists, neonatal nurse practitioners, care managers, and healthcare outpatient schedulers at AdventHealth Celebration for their contributions to the implementation of the discharge guidelines.

Funding

No funding was secured for this study.

Author information

Authors and Affiliations

  1. Staff Neonatologist, AdventHealth Celebration, Orlando, FL, USA

    Jorge M. Lopez Da Re

  2. Biostatistician and Senior Manager, AdventHealth Research Institute, Orlando, FL, USA

    Julie Pepe

  3. Scientific Medical Director, AdventHealth Research Institute, Orlando, FL, USA

    William Oh

Authors
  1. Jorge M. Lopez Da Re
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  2. Julie Pepe
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  3. William Oh
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Contributions

JMLDR conceptualized the study, collected data, and drafted the initial manuscript; JP performed statistical analyses and revised the manuscript; WO supervised the study, interpreted data, and critically revised the manuscript. All authors approved the final manuscript as submitted.

Corresponding author

Correspondence to Jorge M. Lopez Da Re.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The AdventHealth Institutional Review Board approved this study. A waiver of parental consent was granted due to the retrospective nature of the research and the absence of direct interventions. The study was performed in accordance with the Declaration of Helsinki.

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Lopez Da Re, J.M., Pepe, J. & Oh, W. Implementation of the AAP discharge guidelines reduces unplanned readmissions of newborn infants: a single-center study. J Perinatol 46, 454–459 (2026). https://doi.org/10.1038/s41372-025-02485-w

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