ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne1999
Higher neonatal morbidity after routine early hospital discharge: are we sending newborns home too early?
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The trial behind it
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Who cites it
19 citing papers in PubMed, 66 citations in OpenAlex.
- A randomized trial of two public health nurse follow-up programs after early obstetrical discharge: an examination of breastfeeding rates, maternal confidence and utilization and costs of health services.Canadian journal of public health = Revue canadienne de sante publiqueTrial
- Association of early discharge with increased likelihood of hospital readmission in first four weeks for vaginally delivered neonates.Acta paediatrica (Oslo, Norway : 1992) · 2022Article
- The Framework of NICU-discharge Plan System for Preterm Infants in Iran: Duties, Components and Capabilities.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2018Article
- Newborn Length of Stay and Risk of Readmission.Paediatric and perinatal epidemiology · 2017Article
- Factors associated with difficulty accessing health care for infants in Canada: mothers' reports from the cross-sectional Maternity Experiences Survey.BMC pediatrics · 2016Article
- Selecting the best prediction model for readmission.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2012Article
- Length of postnatal hospital stay in healthy newborns and re-hospitalization following early discharge.North American journal of medical sciences · 2011Article
- Neonatal hyperbilirubinemia and early discharge from the maternity ward.European journal of pediatrics · 2009Review
- Why we are still doing so many exchange blood transfusion for neonatal jaundice in Nigeria.World journal of pediatrics : WJP · 2009Article
- Five-year neurodevelopmental outcome of neonatal dehydration.The Journal of pediatrics · 2007Article
- Longer postpartum hospitalization options--who stays, who leaves, what changes?BMC pregnancy and childbirth · 2005Article
- Implementation of a health care policy: an analysis of barriers and facilitators to practice change.BMC health services research · 2005Article
- Early neonatal discharge guidelines: Have we dropped the ball?Paediatrics & child health · 2001Article
- Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2000Article
- Public health nurses' (Phns) perceptions of their role in early postpartum discharge.Canadian journal of public health = Revue canadienne de sante publiqueArticle
- Post-maternity outcomes following health care reform in Alberta: 1992-1996.Canadian journal of public health = Revue canadienne de sante publiqueArticle
- Early discharge of Alberta mothers post-delivery and the relationship to potentially preventable newborn readmissions.Canadian journal of public health = Revue canadienne de sante publiqueArticle
- The safety of Canadian early discharge guidelines. Effects of discharge timing on readmission in the first year post-discharge and exclusive breastfeeding to four months.Canadian journal of public health = Revue canadienne de sante publiqueArticle
- Understanding newborn infant readmission: findings of the Ontario Mother and Infant Survey.Canadian journal of public health = Revue canadienne de sante publiqueArticle
Corrections and comments
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Authors and funding
2 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA growing body of evidence suggests that the trend toward earlier discharge may affect newborn morbidity. The authors assessed how hospital readmission rates were affected by a clinical guideline aimed at discharging newborns from hospital 24 hours after birth.
methodA retrospective before-after cohort study was conducted involving 7009 infants born by uncomplicated vaginal delivery at a large level II hospital in Toronto between Dec. 31, 1993, and Sept. 29, 1997. The primary outcome was a comparison of the rate of hospital readmission among newborns before (5936 infants) and after (1073 infants) the early-discharge policy was implemented (Apr. 1, 1997). The causes for readmission were secondary outcomes.
resultsBefore the early-discharge guideline was implemented, the mean length of stay declined from 2.25 days (95% confidence interval [CI] 2.18-2.32) to 1.88 days (95% CI 1.84-1.92) (p < 0.001). After implementation there was a further decline, to 1.62 days (95% CI 1.56-1.67) (p < 0.001). A total of 126 infants (11.7%) in the early-discharge cohort required readmission by 1 month, as compared with 396 infants (6.7%) in the preguideline cohort (odds ratio 1.86, 95% CI 1.51-2.30). The main reason for early readmission was neonatal jaundice, with a higher rate among infants in the early-discharge cohort than among those in the preguideline cohort (8.6% v. 3.1%; odds ratio 2.96, 95% CI 2.29-3.84).
interpretationDecreases in newborn length of stay may result in substantial increases in morbidity. Careful consideration is needed to establish whether a reduction in length of stay to less than 24 to 36 hours is harmful to babies.
Indexed as
Identifiers
10463045PMC1230500W1948119400What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.