THE EFFECT OF EARLY DISCHARGE AFTER VAGINAL DELIVERY ON NEONATAL READMISSION RATES

Objective: To determine the effect of a structured program for early n eonatal discharge from a tertiary medical center on the risk of neonat al readmission. Methods: An early-discharge program was instituted at our tertiary medical center in July 1993, with the objective of discha rging mothers and infants within 24 hours after vaginal birth. The rea dmission rate of vaginally delivered infants during the early-discharg e period (July 1, 1993, through March 31, 1995) was compared with the rate during a conventional-discharge period (January 1, 1992, through June 30, 1993). Analyses were performed to examine two groups within t he early-discharge group: those discharged within 24 hours of vaginal delivery; and those discharged within 1 hospital day of vaginal delive ry. Results: During the early-discharge period, 1.24% of neonates were readmitted within 10 days of birth, compared with 1.35% during the co nventional-discharge period. In the early-discharge period group, infa nts born vaginally and discharged within 24 hours of birth had a readm ission rate of 1.46% compared with 1.14% for those who stayed longer t han 24 hours after delivery. Similarly, the readmission rate was no di fferent for infants who were discharged within 1 hospital day. The pri mary indications for readmission in both periods were infections and j aundice. Conclusion: Implementation of a structured program for early neonatal discharge does not have an association with increased risk of neonatal readmission to the hospital. (C) 1997 by The American Colleg e of Obstetricians and Gynecologists.