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Association of early discharge with increased likelihood of hospital readmission in first four weeks for vaginally delivered neonates
Author(s) -
Pohjanpää Maria,
Ojala Riitta,
Luukkaala Tiina,
Gissler Mika,
Tammela Outi
Publication year - 2022
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.16290
Subject(s) - medicine , gestational age , neonatal intensive care unit , pediatrics , hospital discharge , jaundice , hospital readmission , intensive care unit , emergency medicine , emergency department , population , intensive care , pregnancy , intensive care medicine , genetics , environmental health , psychiatry , biology
Aim The main aim was to determine whether hospital readmission rates by 28 days of age are elevated with early discharge (ED) in Finland. We sought to identify the causes and predictors of ED, readmission rates, admissions to the intensive care unit (ICU) and death. Methods The data of 333,321 infants were retrieved from nationwide registers. Vaginally delivered single infants at gestational ages (GAs) of ≥37 +0 , born in 2008–2015 and treated in any maternity ward in Finland, were included. ED was defined as discharge on the day of birth or after one night stay on the maternity ward. Results During the study period, the ED and hospital readmission rates increased. Low‐risk infants and those born in high population‐density areas were more likely to be discharged early. ED predicted hospital readmission but not ICU admission or death. The most common reason for readmission was jaundice, followed by infection. ED seemed not to predict severe cardiologic problems. Rather than ED, being born at 38 +0 –38 +6 weeks’ GA significantly predicted ICU admission or death. Conclusion Early discharge seems to be associated with increased hospital readmission. Birth at 38 +0 –38 +6 weeks’ GA was a significant predictor of ICU admission or death, as opposed to early discharged infants.