Association of early discharge with increased likelihood of hospital readmission in first four weeks for vaginally delivered neonates.

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 , 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 -38  weeks' GA significantly predicted ICU admission or death.

CONCLUSION

Early discharge seems to be associated with increased hospital readmission. Birth at 38 -38  weeks' GA was a significant predictor of ICU admission or death, as opposed to early discharged infants.