Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
College of Medicine and Health, South Cloisters, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
Matern Child Health J. 2023 Mar;27(3):527-537. doi: 10.1007/s10995-022-03581-5. Epub 2023 Jan 26.
To explore the predictors of emergency department attendance and admission for mothers and their infants.
Self-reported emergency department (ED) attendance and admission, sociodemographic, mental health, and other measures were recorded at baseline and at 12 months at 4 sites in England between May 2017 and March 2020.
Infants' gestational age (OR 0.73, 95% CI 0.61 to 0.88, p = 0.001), mothers' mental health (OR 2.40, 95% CI 1.30 to 4.41, p = 0.005) and mothers' attendance at ED (OR 2.34, 95% CI 1.13 to 4.84, p = 0.022) predicted infant ED attendance. Frequency of attendance was predicted by ED site (IRR 0.46, 95% CI 0.29 to 0.73, p = 0.001) and mothers' age (IRR 0.96, 95% CI 0.92 to 1.00, p = 0.028). Infant hospital admissions were predominantly for respiratory (40%) and other infectious diseases (21%) and were predicted by previous health problems (OR 3.25, 95% CI 1.76 to 6.01, p < 0.001). Mothers' ED attendance was predicted by mixed or multiple ethnic origin (OR 9.62, 95% CI 2.19 to 42.27, p = 0.003), having a male infant (OR 2.08, 95% CI 1.03 to 4.20, p = 0.042), and previous hospitalisation (OR 4.15, 95% CI 1.81 to 9.56, p = 0.001). Hospital admission was largely for reproductive health issues (61%) with frequency predicted by having attended the ED at least once (IRR 3.39, 95% CI 1.66 to 6.93, p = 0.001), and being anxious or depressed (IRR 3.10, 95% CI 1.14 to 8.45, p = 0.027).
Improving the reproductive and mental health of mothers may help to avoid poor maternal and infant health outcomes and reduce emergency service utilisation and hospitalisation.
探讨母亲及其婴儿急诊就诊和入院的预测因素。
2017 年 5 月至 2020 年 3 月，在英格兰的 4 个地点，对自我报告的急诊就诊和入院、社会人口统计学、心理健康和其他措施进行了基线和 12 个月的记录。
婴儿胎龄（OR 0.73，95%CI 0.61 至 0.88，p=0.001）、母亲的心理健康（OR 2.40，95%CI 1.30 至 4.41，p=0.005）和母亲的急诊就诊（OR 2.34，95%CI 1.13 至 4.84，p=0.022）预测了婴儿的急诊就诊。就诊频率由急诊地点（IRR 0.46，95%CI 0.29 至 0.73，p=0.001）和母亲年龄（IRR 0.96，95%CI 0.92 至 1.00，p=0.028）预测。婴儿住院主要是呼吸系统（40%）和其他传染病（21%），与先前的健康问题有关（OR 3.25，95%CI 1.76 至 6.01，p<0.001）。母亲的急诊就诊由混合或多种族裔（OR 9.62，95%CI 2.19 至 42.27，p=0.003）、男婴（OR 2.08，95%CI 1.03 至 4.20，p=0.042）和以往住院史（OR 4.15，95%CI 1.81 至 9.56，p=0.001）预测。住院主要是生殖健康问题（61%），就诊频率由至少一次就诊（IRR 3.39，95%CI 1.66 至 6.93，p=0.001）和焦虑或抑郁（IRR 3.10，95%CI 1.14 至 8.45，p=0.027）预测。
改善母亲的生殖和心理健康状况，可能有助于避免母婴健康不良结局，并减少急诊服务利用和住院。
