Rosenbaek Charlotte Hoeyer, Zachariassen Gitte, Hoest Bente, Hahn Gitte Holst, Larsen Joan Neergaard, Salmonsen Tenna Gladbo, Horskjaer Malene, Holm Kristina Garne
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Acta Paediatr. 2025 Jun;114(6):1342-1351. doi: 10.1111/apa.17576. Epub 2025 Jan 7.
Homecare for neonates has advanced, but combative analysis of contact methods remains unexplored. The aim was to identify predictors of readmission during homecare and to compare home visit, telemedicine or outpatient visit.
This retrospective study included infants receiving homecare from 1 January 2015 to 31 December 2022. Data were obtained from local databases from six neonatal units in Denmark. The medical records of readmitted infants were reviewed. The main outcome were causes and predictors of readmission during homecare. The secondary outcome was exclusive breastfeeding at discharge.
The cohort consisted of 4827 infants (boys = 54.0%). The rate of unplanned readmissions was 4.6%. A gestational age (GA) <32 weeks (p-value <0.01) or bronchopulmonary dysplasia (BPD) (p-value <0.01) were predictors of readmission. There was no difference in unplanned readmissions based on contact method (p-value = 0.46 for telemedicine, p-value = 0.11 for outpatient visit). The overall exclusive breastfeeding rate at discharge from homecare was 64.1%.
Homecare can be provided for preterm and term infants while establishing oral feeding, with caution on infants with a GA < 32 or BPD. All types of contact methods during homecare investigated can be provided equally in relation to readmission and exclusive breastfeeding.
新生儿家庭护理已有所发展，但对接触方式的对比分析仍未得到探索。本研究旨在确定家庭护理期间再入院的预测因素，并比较家访、远程医疗或门诊就诊的效果。
这项回顾性研究纳入了2015年1月1日至2022年12月31日期间接受家庭护理的婴儿。数据来自丹麦六个新生儿病房的本地数据库。对再入院婴儿的病历进行了审查。主要结局是家庭护理期间再入院的原因和预测因素。次要结局是出院时纯母乳喂养情况。
该队列包括4827名婴儿（男孩占54.0%）。计划外再入院率为4.6%。胎龄（GA）<32周（p值<0.01）或支气管肺发育不良（BPD）（p值<0.01）是再入院的预测因素。基于接触方式的计划外再入院情况无差异（远程医疗的p值=0.46，门诊就诊的p值=0.11）。家庭护理出院时的总体纯母乳喂养率为64.1%。
在建立经口喂养时可为早产儿和足月儿提供家庭护理，对于GA<32或患有BPD的婴儿需谨慎。就再入院和纯母乳喂养而言，所研究的家庭护理期间的所有接触方式均可同等提供。
