APHM, Hospital University La Conception, Neonatal Unit, Service de Médecine Néonatale, 147 Boulevard Baille, 13005, Marseille, France.
Regional Health Agency, Provence-Alpes-Côte d'Azur, France.
World J Pediatr. 2024 Nov;20(11):1138-1144. doi: 10.1007/s12519-024-00841-y. Epub 2024 Oct 12.
Newborn care guidelines recommend assessments within a week of discharge from maternity care. However, the optimal timing and effectiveness to prevent neonatal hospital readmission are debated. This study aimed to determine the association between early follow-up visits (EFVs) within three days of postpartum discharge and hospital readmission of newborns up to 15 days of life.
This population-based data-linkage study used data from the French National Health Care Database. "Healthy" singleton term infants with a gestational age (GA) of ≥ 36 weeks, born between January 1, 2017, and November 30, 2018, in Southern France, were included. A multivariate regression analysis was performed.
Among the 67,359 included infants, 1519 (2.25%) were hospitalized. The principal causes of hospitalization were infectious diseases (42.4%) and jaundice or growth/nutrition disorders (36.1%). Hospitalized infants were more likely to be born to young and socioeconomically deprived mothers, to be male (54.4% vs. 50.6%, P < 0.001), or born early (GA < 38 weeks; 28.5% vs. 20.5%, P < 0.001). They received 6% less EFVs than non-hospitalized infants (63.7% vs. 67.8%, P < 0.001). The multivariable regression logistic analysis revealed that infants who received EFVs had 13% lower odds of being hospitalized than infants without EFVs, with an adjusted odds ratio of 0.87 (95% confidence interval = 0.78-0.96; P < 0.01).
EFVs within three days were associated with a 13% reduction in the rate of neonatal hospital readmission. Therefore, EFVs should be implemented to improve infant health and reduce healthcare costs.
新生儿护理指南建议在产妇出院后一周内进行评估。然而,预防新生儿住院再次入院的最佳时机和效果仍存在争议。本研究旨在确定产妇出院后三天内进行早期随访(EFV)与新生儿在 15 天内住院的关系。
这是一项基于人群的数据分析研究,使用了法国国家医疗保健数据库的数据。纳入 2017 年 1 月 1 日至 2018 年 11 月 30 日在法国南部出生的胎龄(GA)≥36 周的“健康”单胎足月婴儿。进行了多变量回归分析。
在纳入的 67359 名婴儿中,有 1519 名(2.25%)住院。住院的主要原因是传染病(42.4%)和黄疸或生长/营养障碍(36.1%)。住院婴儿的母亲更年轻,社会经济地位较低,男孩(54.4% vs. 50.6%,P < 0.001)或早产(GA < 38 周;28.5% vs. 20.5%,P < 0.001)的可能性更高。他们接受的 EFV 比非住院婴儿少 6%(63.7% vs. 67.8%,P < 0.001)。多变量回归逻辑分析显示,接受 EFV 的婴儿住院的可能性比未接受 EFV 的婴儿低 13%,调整后的比值比为 0.87(95%置信区间 0.78-0.96;P < 0.01)。
三天内进行 EFV 与新生儿住院再次入院率降低 13%相关。因此,应实施 EFV 以改善婴儿健康并降低医疗保健成本。