Factors Affecting Readmissions of Term and Late Preterm Infants in the Neonatal Period
Authors/Creators
- 1. Neonatology Fellow, Department of Neonatology, NICE Hospital for Women, New Born and Children, Hyderabad
- 2. Senior Consultant, Department of Neonatology, NICE Hospital for Women, New Born and Children, Hyderabad
- 3. Consultant, Department of Neonatology, NICE Hospital for Women, New Born and Children, Hyderabad
- 4. Neonatalogy Resident, NICE Hospital for Women, New Born and Children, Hyderabad
Description
Objective: To determine the incidence of hospital readmissions, the etiologies, and to analyze the risk factors for readmissions of Late Preterm infants (LPI) and term infants (TI) in the neonatal period. Methods: It was a retrospective cohort study conducted at Nice Hospital for Women and Children, Hyderabad, India. The study protocol was approved by the institutional ethics committee. Late preterm and TIs > 34 weeks of gestational age (GA), discharged alive either from the post-natal ward or NICU were included in the study. Neonates with congenital anomalies, who died before discharge, and who were readmitted >28 days of age were excluded from this study. The relevant demographic, antenatal, perinatal and neonatal data of the study infants as well as their mothers were recorded in the pre-designed proforma. Mann Whitney U test and Chi square tests were used for statistical analysis. A p value < 0.05 was considered statistically significant. Results: A total of 1396 (100%) neonates were included in this study. Thirty-eight (2.72%) of the LPIs were readmitted and 3.87% (54) were in the TI category. When neonatal characteristics were compared, statistically significant difference was seen in both categories in birth weight, jaundice requiring phototherapy, sepsis and time to full feeding respectively. Poor weight gain was the leading cause of readmission in both categories; though not statistically significant. Maximum LPIs (23) and TIs (36) were admitted in the monsoon; though statistically no significant difference was observed. Conclusion: Poor weight gain, respiratory infection, jaundice, poor feeding/lethargy and feeding difficulty/vomiting were identified as reasons for readmission. Metacentric studies with a large sample size are recommended.
Abstract (English)
Objective: To determine the incidence of hospital readmissions, the etiologies, and to analyze the risk factors for readmissions of Late Preterm infants (LPI) and term infants (TI) in the neonatal period. Methods: It was a retrospective cohort study conducted at Nice Hospital for Women and Children, Hyderabad, India. The study protocol was approved by the institutional ethics committee. Late preterm and TIs > 34 weeks of gestational age (GA), discharged alive either from the post-natal ward or NICU were included in the study. Neonates with congenital anomalies, who died before discharge, and who were readmitted >28 days of age were excluded from this study. The relevant demographic, antenatal, perinatal and neonatal data of the study infants as well as their mothers were recorded in the pre-designed proforma. Mann Whitney U test and Chi square tests were used for statistical analysis. A p value < 0.05 was considered statistically significant. Results: A total of 1396 (100%) neonates were included in this study. Thirty-eight (2.72%) of the LPIs were readmitted and 3.87% (54) were in the TI category. When neonatal characteristics were compared, statistically significant difference was seen in both categories in birth weight, jaundice requiring phototherapy, sepsis and time to full feeding respectively. Poor weight gain was the leading cause of readmission in both categories; though not statistically significant. Maximum LPIs (23) and TIs (36) were admitted in the monsoon; though statistically no significant difference was observed. Conclusion: Poor weight gain, respiratory infection, jaundice, poor feeding/lethargy and feeding difficulty/vomiting were identified as reasons for readmission. Metacentric studies with a large sample size are recommended.
Files
IJPCR,Vol15,Issue3,Article196.pdf
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Additional details
Dates
- Accepted
-
2023-03-23
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue3,Article196.pdf
- Development Status
- Active
References
- 1. Tomashek KM, Shapiro-Mendoza CK, Weiss J, et al. Early discharge among late preterm and term newborns and risk of neonatal morbidity. Semin Perinatol. 2006; 30(2): 61 – 8. 2. Medoff-Cooper B, Bakewell-Sachs S, BuusFrank ME, Santa-Donato A; NearTerm Infant Advisory Panel. The AWHONN Near term Infant Initiative: a conceptual framework for optimizing health for near-term infants. J Obstet Gynecol Neonatal Nurs. 2005; 34(6): 666 – 71. 3. Escobar GJ, Clark RH, Greene JD. Shortterm outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol. 2006; 30(1): 28 – 33. 4. Martin JA, Hamilton BE, Ventura SJ, Osterman MJ, Mathews TJ. Births: fi nal data for 2011. Natl Vital Stat Rep. 2013; 62(1): 1 – 70. 5. Oddie SJ, Hammal D, Richmond S, Parker L. Early discharge and readmission to hospital in the fi rst month of life in the Northern Region of the UK during 1998: a case cohort study. Arch Dis Child. 2005; 90(2): 119 – 24. 6. Karnati S, Kollikonda S, AbuShaweesh J. Late preterm infants - Changing trends and continuing challenges. Int J Pediatr Adolesc Med. 2020; 7(1): 36 – 44. 7. Premji SS, Young M, Rogers C, Reilly S. Transitions in the early-life of late preterm infants: vulnerabilities and implications for postpartum care. J Perinat Neonatal Nurs. 2012; 26(1): 57 – 68. 8. Goyal N, Zubizarreta JR, Small DS, Lorch SA. Length of stay and readmission among late preterm infants: an instrumental variable approach. Hosp Pediatr. 2013; 3(1): 7 – 15. 9. Danielsen B, Castles AG, Damberg CL, Gould JB. Newborn discharge timingand AQ4 readmissions: California, 1992-1995. Pediatrics. 2000; 106: 31 – 9. 10. Kair LR, Goyal NK. Hospital Readmission Among Late Preterm Infants: New Insights and Remaining Questions. Hosp Pediatr. 2022; 12(7): e273 – e274. 11. Moyer LB, Goyal NK, Meinzen-Derr J, Ward LP, Rust CL, Wexelblatt SL, Greenberg JM. Factors associated with readmission in late-preterm infants: a matched case-control study. Hospital pediatrics. 2014; 4(5): 298 – 304. 12. Ray KN, Lorch SA. Hospitalization of early preterm, late preterm, and term infants during the first year of life by gestational age. Hosp Pediatr. 2013; 3(3): 194 – 203. 13. Blumovich A, Mangel L, Yochpaz S, Mandel D, Marom R. Risk factors for readmission for phototherapy due to jaundice in healthy newborns: a retrospective, observational study. BMC Pediatr. 2020; 20(1): 248. 14. Coquery SS, Georges A, Cortey A, Floch C, Avran D, Gatbois E, MehlerJacob C, de Stampa M. Discharge of newborns with risk factors of severe hyperbilirubinemia: description of a hospital at home-based care monitoring and phototherapy. Eur J Pediatr. 2022; 181(8): 3075 – 84. 15. Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfi eld W, Weiss J, Evans S. Risk factors for neonatal morbidity and mortality among healthy, late preterm newborns. Semin Perinatol. 2006; 30(2): 54 – 60. 16. Perme T, Škafar Cerkvenik A, Grosek Š. Newborn Readmissions to Slovenian Children's Hospitals in One Summer Month and One Autumn Month: A Retrospective Study. Pediatr Neonatol. 2016; 57(1):47 – 52. 17. Osuh J., Sunmola A. M., Balogun S. K., & Ishola A. A. Evaluation of Blood Lead Levels (Bll) of Albino Rat Offspring (Weanlings) Prenatally Exposed to Lead and Moringa Oleifera. Journal of Medical Research and Health Sciences, 2021; 4(12): 1610–1628.