HOSPITAL READMISSION AND MORBIDITY FOLLOWING EARLY NEWBORN DISCHARGE

To examine causes of newborn hospital readmission and morbidity relate d to early nursery discharge, we reviewed the charts of 664 newborns r eadmitted from home under the age of 15 days, between 1993 and 1995. E arly discharge (ED) was defined as nursery length of stay of 12 days. Morbidity related to ED: onset of symptoms within 1 day of ED; and in diseases with insidious onset: serum bilirubin level >20 mg/dL (340 mu mol/L), or dehydration following poor breastfeeding since birth. Seve nteen percent of all readmitted infants had ED-related morbidity; 9% h ad major morbidity Onset of symptoms prior to the age of 3 days occurr ed in 43% of ductal-dependent cardiac lesions, intestinal obstruction, seizures, and major infections. Morbidity was less pronounced in infa nts who were followed up within 2 days following ED. Specific findings related to subsequent morbidity were identified in the perinatal hist ory of infants who were readmitted with major infections and with hype rbilirubinemia, Our findings suggest that: (1) close to half of the ca ses with acute-onset major morbidity can be identified within 3 days o f birth, and (2) attention to the perinatal history and timely follow- up will contribute to a reduction in both morbidity and complications.