Neonatal visits to the pediatric emergency center and its implications on postnatal discharge practices in qatar.

J Clin Neonatol

Neonatal Perinatal Medicine Division, Pediatric Emergency Center, Hamad Medical Corporation, Weill Cornel Medical Collage, Doha, Qatar.

Published: January 2013

AI Article Synopsis

  • The study aimed to assess the impact of early postnatal discharge on neonatal health outcomes in Qatar, analyzing data from neonates visiting Pediatric Emergency Centers.
  • Neonates discharged within the first 24 hours post-birth had similar re-hospitalization rates compared to those discharged later, but were more likely to require observation or clinic referrals.
  • The findings suggest a need for better follow-up services for discharged neonates, but do not support delaying discharge for healthy infants based on the collected data.

Article Abstract

Background: An early discharge from postnatal policy has been practiced at Women's Hospital, Hamad Medical Corporation.

Aim: This observational cohort study was conducted to evaluate the effect of early postnatal discharge practice on neonatal morbidity in the State of Qatar.

Setting And Design: This is a data-based cohort study. All neonates ≤28 days visiting the Pediatric Emergency Centers (PEC) were evaluated for the need for re-hospitalization, referral for clinic appointments, or observation at the PEC setting.

Materials And Methods: Differences in outcome rates were compared in neonates who visited in the first 24 hours postnatal discharge (2-3 days of life) and those who visited after the third day of life.

Statistical Analysis: Crude differences in incidence rate assessed by χ(2) or Fisher exact test were applicable.

Results: Of 3528 PEC visits for 1915 neonates, 1.7% required admission (3.1% of neonates), 8.4% were observed, 1.1% were referred to a clinic, and the remaining were discharged home. There was no significant difference in re-hospitalization rates of neonates visiting PEC in the first 3 days and those visiting at a later age (OR 0.78, 95% CL 0.19-3.23, P=1). However, early presentations to PEC was more likely to result in periods of observation (OR 1.88, 95% CL 1.17-3.04, P=0.01), or clinic referral (OR 4.96, 95% CL 2.16-11.38, P=0.001) when compared to older neonates. Moreover, those who presented early were significantly more likely to revisit any of the PECs with in the 28 days period (OR 3.20, 95% CL 2.17-4.97, P<0.0001).

Conclusion: These results clearly demonstrate the need for a structured early post-discharge follow-up service that addresses the needs of all neonates and their families. The results, however, do not provide sufficient evidence that delaying postnatal discharges for apparently healthy neonates will provide significant health benefits to these neonates and their families.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761961PMC
http://dx.doi.org/10.4103/2249-4847.109238DOI Listing

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