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Efficacy of Early Newborn Discharge in a Middle-class Population

Efficacy of Early Newborn Discharge in a Middle-class Population Abstract • The safety of early newborn discharge was assessed by determining the incidence, time of onset, and nature or problems requiring hospitalization that appeared in the first two weeks of life among 1,735 consecutively born term infants in a private metropolitan hospital. Infants with and without abnormalities during the initial six-hour transitional period were compared. Of 1,583 Initially well infants, 11(0.7%) had problems other than jaundice develop that required hospitalization in the first three days of life. In contrast, 42 (28%) of the 152 infants with abnormal transitional periods required prolonged hospital care; this was statistically significant. The nature of the problems occurring before and after 72 hours was similar, jaundice being the most common and occurring with equal frequency in both periods. Most illness requiring hospitalization in the first three days of life could have been safely detected during an outpatient visit; these findings, in addition to a cost-benefit estimate, suggest that early discharge of initially well infants with careful follow-up may be an effective alternative to a traditional three-day stay. (AJDC 1984;138:1041-1046) References 1. Committee on Fetus and Newborn, American Academy of Pediatrics: Criteria for early infant discharge and follow-up evaluation . Pediatrics 1980;65:A86. 2. American Academy of Pediatrics, American College of Obstetricians and Gynecologists: Guidelines for Perinatal Care . Evanston, Ill, American Academy of Pediatrics, 1983, pp 81-93. 3. Desmond MM, Rudolph AJ, Phitaksphraiwan P: The transitional care nursery: A mechanism for preventive medicine in the newborn . Pediatr Clin North Am 1966;13:651-668. 4. Yanover MJ, Jones D, Miller MD: Perinatal care of low-risk mothers and infants: Early discharge with home care . N Engl J Med 1976; 294:702-705.Crossref 5. Britton JR, Britton H: Growth parameters for term newborns in southern Arizona , abstracted. Clin Res 1984;32:121A. 6. Maisels MJ: Neonatal jaundice , in Avery GB (ed): Neonatology . Philadelphia, JB Lippincott Co, 1981, p 511. 7. Fletcher RH, Fletcher SW, Wagner EH: Clinical Epidemiology . Baltimore, Williams & Wilkins Co, 1983, p 54. 8. Sunshine P, Sinatra FR, Mitchell CH, et al: Disorders of the small intestine , in Faranoff AM, Martin RJ (eds): Behrman's Neonatal-Perinatal Medicine . St Louis, CV Mosby Co, 1983, pp 502-504. 9. Forshall I: Septic umbilical arteritis . Arch Dis Child 1957;32:25-30.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Efficacy of Early Newborn Discharge in a Middle-class Population

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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1984.02140490041010
Publisher site
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Abstract

Abstract • The safety of early newborn discharge was assessed by determining the incidence, time of onset, and nature or problems requiring hospitalization that appeared in the first two weeks of life among 1,735 consecutively born term infants in a private metropolitan hospital. Infants with and without abnormalities during the initial six-hour transitional period were compared. Of 1,583 Initially well infants, 11(0.7%) had problems other than jaundice develop that required hospitalization in the first three days of life. In contrast, 42 (28%) of the 152 infants with abnormal transitional periods required prolonged hospital care; this was statistically significant. The nature of the problems occurring before and after 72 hours was similar, jaundice being the most common and occurring with equal frequency in both periods. Most illness requiring hospitalization in the first three days of life could have been safely detected during an outpatient visit; these findings, in addition to a cost-benefit estimate, suggest that early discharge of initially well infants with careful follow-up may be an effective alternative to a traditional three-day stay. (AJDC 1984;138:1041-1046) References 1. Committee on Fetus and Newborn, American Academy of Pediatrics: Criteria for early infant discharge and follow-up evaluation . Pediatrics 1980;65:A86. 2. American Academy of Pediatrics, American College of Obstetricians and Gynecologists: Guidelines for Perinatal Care . Evanston, Ill, American Academy of Pediatrics, 1983, pp 81-93. 3. Desmond MM, Rudolph AJ, Phitaksphraiwan P: The transitional care nursery: A mechanism for preventive medicine in the newborn . Pediatr Clin North Am 1966;13:651-668. 4. Yanover MJ, Jones D, Miller MD: Perinatal care of low-risk mothers and infants: Early discharge with home care . N Engl J Med 1976; 294:702-705.Crossref 5. Britton JR, Britton H: Growth parameters for term newborns in southern Arizona , abstracted. Clin Res 1984;32:121A. 6. Maisels MJ: Neonatal jaundice , in Avery GB (ed): Neonatology . Philadelphia, JB Lippincott Co, 1981, p 511. 7. Fletcher RH, Fletcher SW, Wagner EH: Clinical Epidemiology . Baltimore, Williams & Wilkins Co, 1983, p 54. 8. Sunshine P, Sinatra FR, Mitchell CH, et al: Disorders of the small intestine , in Faranoff AM, Martin RJ (eds): Behrman's Neonatal-Perinatal Medicine . St Louis, CV Mosby Co, 1983, pp 502-504. 9. Forshall I: Septic umbilical arteritis . Arch Dis Child 1957;32:25-30.Crossref

Journal

American Journal of Diseases of Children – American Medical Association

Published: Nov 1, 1984

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