Impact of early discharge from the maternity ward on the risk of neonatal rehospitalization: A case-control study.

Abstract

Background: The time for newborn discharge from the maternity ward has been shortened in recent decades with consequences that are still debated.

Objectives: The primary objective of this study was to establish whether early discharge could be a risk factor for rehospitalization in the neonatal period. Second, we aimed to study the incidence of neonatal hospitalizations and their causes. Next, we tried to determine other possible risk factors for rehospitalization after discharge.

Methods and setting: This is a retrospective, single-center, case-control study collecting data on newborns rehospitalized in the first 28 days of life at Nancy University Hospital, after their discharge from the maternity ward. These newborns were born between 01/06/2021 and 31/05/2022 and were matched with two healthy infants who did not require rehospitalization according to term and month of birth. A logistic regression model was used to evaluate the association between early discharge and risk of hospitalization.

Results: 2,054 healthy full-term babies were born during the study period; 108 (5%) were rehospitalized and compared to 219 randomly selected newborns who did not required hospitalization. Among the 108 cases included, 42 (38.9%) obtained early discharge versus 91 out of 219 (41.6%) controls. Multivariate logistic regression showed no significant association between early discharge and risk of hospitalization (ORa=1.1 [95%CI: 0.7 to 1.8], p = 0.69). However, phototherapy treatment during the maternity ward stay was a significant risk factor for rehospitalization (ORa=5.O [2.5 to 9.9], p < 0.0001). The main causes of hospitalization were jaundice and respiratory infections.

Conclusion: Early discharge from the maternity ward does not constitute a risk factor for readmission in the neonatal period in this study. Changes in perinatal practices, such as ambulatory delivery and very early discharge, should be included in revised recommendations.