Vohr B, McGowan E, Keszler L, O'Donnell M, Hawes K, Tucker R
Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA.
Alpert School of Medicine, Brown University, Providence, RI, USA.
J Perinatol. 2018 Feb;38(2):185-190. doi: 10.1038/jp.2017.136. Epub 2017 Sep 14.
To evaluate effects of a transition home program (THP) and risk factors on emergency room (ER) use within 90 days of discharge for preterm (PT) infants <37 weeks gestation.
This is a prospective 3-year cohort study of 804 mothers and 954 PT infants. Mothers received enhanced neonatal intensive care unit transition support services until 90 days postdischarge. Regression models were run to identify the effects of THP implementation year and risk factors on ER visits.
Of the 954 infants, 181 (19%) had ER visits and 83/181 (46%) had an admission. In regression analysis, THP year 3 vs year 1 and human milk at discharge were associated with decreased risk of ER visits, whereas increased odds was associated with non-English speaking, maternal mental health disorders and bronchopulmonary dysplasia.
Enhanced THP services were associated with a 33% decreased risk of all ER visits by year 3. Social and environmental risk factors contribute to preventable ER visits.
评估过渡家庭计划(THP)及风险因素对孕周小于37周的早产(PT)婴儿出院后90天内急诊室(ER)就诊情况的影响。
这是一项针对804名母亲和954名PT婴儿的前瞻性3年队列研究。母亲们在出院后90天内接受强化的新生儿重症监护病房过渡支持服务。采用回归模型来确定THP实施年份及风险因素对急诊就诊的影响。
在954名婴儿中,181名(19%)有急诊就诊,其中83/181名(46%)住院。回归分析显示,与第1年相比,第3年实施THP以及出院时母乳喂养与急诊就诊风险降低相关,而急诊就诊几率增加与非英语母语、母亲心理健康障碍和支气管肺发育不良相关。
到第3年,强化的THP服务使所有急诊就诊风险降低了33%。社会和环境风险因素导致了可预防的急诊就诊。