早期婴儿非选择性剖宫产术后再入院的流行病学。

Epidemiology of readmissions in early infancy following nonelective cesarean delivery.

机构信息

Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.

Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

J Perinatol. 2021 Jan;41(1):24-31. doi: 10.1038/s41372-020-0730-1. Epub 2020 Jul 15.

DOI:10.1038/s41372-020-0730-1

PMID:32669643

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7854783/

Abstract

OBJECTIVE

Determine incidence and risk factors for readmissions in early infancy.

STUDY DESIGN

Secondary analysis of data from the Cesarean Section Optimal Antibiotic Prophylaxis trial. All unplanned revisits (unplanned clinic, ER visits, and hospital readmissions) and hospital readmissions (initial discharge to 3-month follow-up) were analyzed.

RESULTS

295 (15.9%) of 1850 infants had revisits with risk factors being ethnicity (adjusted odds ratio (aOR): 0.6 for Hispanic), maternal postpartum antibiotics (1.89), azithromycin treatment (1.22), small for gestational age (1.68), apnea (3.82), and hospital stay after birth >90th percentile (0.49). 71 (3.8%) of 1850 infants were readmitted with risk factors being antenatal steroids (aOR 2.49), elective repeat C/section (0.72), postpartum maternal antibiotics (2.22), O requirement after delivery room (2.82), and suspected/proven neonatal sepsis (0.55).

CONCLUSION(S): Multiple risk factors were identified, suggesting potential impact on the neonatal microbiome (maternal postpartum antibiotics) or issues related to access/cost of care (Hispanic ethnicity associated with fewer revisits).

摘要

目的

确定婴儿早期再入院的发生率和相关因素。

研究设计

对剖宫产最佳抗生素预防试验数据的二次分析。所有非计划性复诊（非计划性门诊、急诊就诊和住院再入院）和住院再入院（初始出院至 3 个月随访）均进行了分析。

结果

在 1850 名婴儿中，有 295 名（15.9%）婴儿进行了复诊，其危险因素包括种族（调整后的优势比（aOR）：西班牙裔为 0.6）、产妇产后使用抗生素（1.89）、阿奇霉素治疗（1.22）、小于胎龄儿（1.68）、呼吸暂停（3.82）和出生后住院时间>第 90 百分位数（0.49）。在 1850 名婴儿中，有 71 名（3.8%）婴儿再入院，其危险因素包括产前使用类固醇（aOR 2.49）、择期再次剖宫产（0.72）、产妇产后使用抗生素（2.22）、分娩后需要吸氧（2.82）和疑似/确诊新生儿败血症（0.55）。