Early newborn hospital discharge and readmission for mild and severe jaundice

Objectives: To further explore the relationship of early newborn hospital d ischarge and readmission for jaundice, and to determine if early hospital d ischarge was associated with increased severity of jaundice among those rea dmitted. Methods We performed a population-based case-control study using Washington State vital statistics, birth certificates, and hospital discharge abstrac ts from 1991 to 1995. Cases included 750 infants readmitted to the hospital for jaundice in the first 2 weeks of life; controls included 3192 infants not readmitted. Infants with severe medical condition and those delivered b y cesarean section were excluded. Early hospital discharge was defined as f ewer than 30 hours in the hospital; late hospital discharge, 30 to 78 hours . We assessed the risk for hospital readmission for jaundice, for hospital readmissions classified as brief (less than or equal to 2 days) or;prolonge d (>2 days), and for hospital readmissions classified as uncomplicated or c omplicated. Results: Infants discharged from the hospital early were at increased risk for jaundice (odds ratio, 1.34 [95% confidence interval, 1.10-1.64] adjuste d for birth year, gestational age, maternal race and age, parity, payer, an d infant sex). The risk associated with early hospital discharge was simila r regardless of whether the hospital readmission was brief or prolonged and complicated or uncomplicated. One hundred twenty-two infants would have re , stay for longer than 30 hours to avoid 1 jaundice readmission. Conclusions: While newborns discharged from the hos pital early are at incr eased risk for hospital readmission for jaundice, the clinical significance is limited. Mandating longer neonatal stays may not be the most effective strategy to prevent hospital readmission for jaundice and its complications .