Readmission of late preterm and term neonates in the neonatal period

Kardum, Darjan; Serdarušić, Ivana; Biljan, Borna; Šantić, Krešimir; Živković, Vinko

doi:10.1016/j.clinsp.2022.100005

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…Neonates admitted to the NICU have lower rates of readmission to the hospital than neonates admitted to the nursery. 27 An intensive care environment experience offers more benefits than LDA supplementation when it comes to neonatal readmissions.…”

Section: Discussionmentioning

confidence: 99%

Impact of Aspirin Supplementation for Pre-Eclampsia Prevention on Neonatal Outcomes

Campo

Fogel²,

Na³

et al. 2023

kjm

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Introduction. Preeclampsia affects approximately 4.6% of pregnancies worldwide. In 2018, ACOG updated their low dose aspirin (LDA) supplementation recommendation to include pregnant women at moderate risk for preeclampsia. In addition to the potential benefit of LDA supplementation for delaying or preventing preeclampsia, LDA supplementation can affect neonatal outcomes. We study the association of LDA supplementation with six neonatal outcomes: length of stay (LOS) in hospital, NICU admission, hospital readmission, birth weight (BW), one-minute Apgar score, and five-minute Apgar score in a sample of mostly minority pregnant women from Hispanic and Black race/ethnicities. Methods. This was a retrospective study of 634 patients from January 2018 through April 2021.Our main predictor variable was maternal LDA supplementation on 6 neonatal outcomes: NICU admission, neonatal readmission, one and five minute Apgar scores, neonatal BW and hospital LOS. We adjusted for demographics, comorbidities and maternal high- or moderate-risk designation per ACOG guidelines. Results. We found that high-risk designation was associated with neonatal increased rate of NICU admission (OR: 3.80, 95% CI: 2.02, 7.13, p<0.001), LOS (B=0.15, SE=0.04, p<0.001) and decreased birthweight (B=-442.10, SE=75.07, p <0.001). We found no significant association with LDA supplementation and NICU admission, readmission, low one and five minute Apgar scores, BW and LOS. Conclusions. We did not find any association of LDA supplementation with NICU admission, hospital readmission, low one-minute or five-minute Apgar score, birthweight, and LOS. Clinicians recommending maternal LDA supplementation should be aware that LDA supplementation does not appear to provide any benefits for these neonatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Impact of Aspirin Supplementation for Pre-Eclampsia Prevention on Neonatal Outcomes

Campo

Fogel²,

Na³

et al. 2023

kjm

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“…However, the LPIs' physiologic and metabolic immaturity increases their risk for complications such as breastfeeding difficulty, hypoglycemia, hyperbilirubinemia, hypothermia, respiratory distress, and neurologic issues (Ahmed & Rojjanasrirat, 2021). Hospital readmission rates for LPIs are double that of term infants (4.2% vs. 2.1%), and risk for rehospitalization is higher for LPIs who were never admitted to the NICU, had short NICU stays, or who were discharged from the hospital after less than 2 nights (Kardum et al, 2022; Speer et al, 2021). Later in life, LPIs have a higher risk for cognitive and speech delays, behavioral problems, and psychological disorders (Karnati et al, 2020).…”

mentioning

confidence: 99%

Standardizing Care of the Late Preterm Infant

Smith,

Yonkaitis,

Reigart

2023

McN: The American Journal of Maternal/Child Nursing

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Background: Late preterm infants are infants born between 34 and 36 6/7 weeks gestation. Compared to term infants, late preterm infants are at increased risk for breastfeeding difficulties, hypoglycemia, hyperbilirubinemia, and hypothermia due to their relative physiologic and metabolic immaturity. Problem: Medical record reviews performed at a level III maternal and newborn hospital in central Illinois revealed only 64% of late preterm infants admitted to the newborn nursery received care per the unit late preterm infant policy. The aim of this quality improvement project was to increase nurse adherence to the policy to 80%. Methods: Between May 2022 and September 2022, several interventions were implemented for maternal–child nurses and support clinicians: an education offering, creation of a late preterm infant-specific breastfeeding log, and electronic medical record updates. Post-intervention medical record reviews measured policy adherence through documentation of feeding sessions, hypoglycemia, hypothermia, and hyperbilirubinemia. Descriptive statistics were performed to determine improvement. Results: Nurse adherence to the late preterm infant policy increased to 90% over the period of the project. Clinical Implications: Late preterm infant care protocols should be in place in all newborn nurseries. Late preterm infant policy adherence can be supported through electronic medical record prompts, use of a late preterm infant-specific breastfeeding log, and continuing education.

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Characteristics of late preterm infant readmissions: A systematic review

Joyner,

Papermaster,

Champion

2024

J Am Assoc Nurse Pract

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Background: Prematurity represents a critical health disparity. It is important to note that late preterm (LPT) infants comprise the majority of preterm births, yet they are the least studied within the premature population. Evidence-based practice guidelines are now a decade old, indicating the potential need for review and revision. Objectives: This systematic review proposed the assessment of sociodemographic characteristics of LPT infants, clinical practice standards, and associated hospital readmission rates, mortality, and morbidity to determine the need for revision of evidence-based practice guidelines for these infants. Data Sources: The Preferred Reporting System Items for Systematic Reviews and Meta Analysis methodology provided the framework for the completion of this review. Literature searches of PubMed/Medline (Ovid), Web of Science, Cumulative Index of Nursing, and Allied Health Literature Plus databases and citation searches included articles published after 2012 using the search terms “late preterm infants,” “readmissions,” and “readmission rates.” Conclusions: The literature search identified 11 studies meeting search criteria. These studies included quasi experimental, retrospective, and prospective cohort studies. These studies highlighted the characteristics of LPT infants that potentially contribute to increased readmission rates, morbidity and mortality rates, health care costs, and long-term health inequities. Overall findings indicate the need for review and revision of evidence-based practice guidelines for these infants. Implications for practice: This systematic review manifests the vulnerability of LPT infants and the accompanying need for up-to-date clinical practice guidelines to effectively reduce their morbidity and mortality rates, hospital readmissions rates, and burden of health care costs.

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Readmission of late preterm and term neonates in the neonatal period

Cited by 4 publications

References 21 publications

Impact of Aspirin Supplementation for Pre-Eclampsia Prevention on Neonatal Outcomes

Impact of Aspirin Supplementation for Pre-Eclampsia Prevention on Neonatal Outcomes

Standardizing Care of the Late Preterm Infant

Characteristics of late preterm infant readmissions: A systematic review

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