Factors Associated With Readmission in Late-Preterm Infants: A Matched Case-Control Study

Moyer, Laurel; Goyal, Neera K.; Meinzen‐Derr, Jareen; Ward, Laura P.; Rust, Christina L.; Wexelblatt, Scott L.; Greenberg, J. M.

doi:10.1542/hpeds.2013-0120

Cited by 22 publications

(40 citation statements)

References 25 publications

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“…It remains unclear what the optimal length of stay should be (whether the infant is in the NICU or well-infant nursery) to optimize the establishment of breastfeeding and prevent unnecessary readmissions. 24,25 Our research provides evidence that single mothers, those with lower education, and those who are obese are high-risk subpopulations of mothers of late preterm infants who could benefit more from enhanced support, both in the hospital and after discharge. We also identified milk supply concerns and breastfeeding difficulties as the top reasons why mothers of late preterm infants discontinue breastfeeding.…”

Section: Discussionmentioning

confidence: 79%

Breastfeeding Continuation Among Late Preterm Infants: Barriers, Facilitators, and Any Association With NICU Admission?

Kair

Colaizy

2016

Hospital Pediatrics

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A B S T R A C T BACKGROUND AND OBJECTIVES:Late preterm birth (at 34-36 6/7 weeks' gestation) is a risk factor for early breastfeeding cessation. The objective of this study was to determine barriers to and facilitators of breastfeeding continuation among late preterm infants (LPI) and to compare the barriers faced by LPI admitted to the well nursery versus the NICU. RESULTS: A total of 2530 mothers of LPI were surveyed. Odds of breastfeeding initiation were similar among LPI admitted to the NICU versus the well nursery (adjusted odds ratio, 1.24 [95% confidence interval, 0.88-1.73]; P 5 .209). Odds of breastfeeding for $10 weeks were no different between LPI admitted to the NICU versus those admitted to the well-nursery (adjusted odds ratio, 1.02 [95% confidence interval, 0.73-1.43]; P 5 .904). Factors associated with increased odds of breastfeeding for $10 weeks among LPI were higher maternal education, mother being married, and normal maternal BMI. Regardless of NICU admission, the top reasons cited by mothers of LPI for early breastfeeding discontinuation were perceived inadequate milk supply and nursing difficulties. METHODS:CONCLUSIONS: Among LPIs, NICU admission was not associated with early breastfeeding cessation. Mothers of LPIs with lower odds of sustaining breastfeeding for at least 10 weeks were single mothers, those with a high school education only, and those who were obese. Breastfeeding support should be enhanced for LPIs and should address perceived maternal milk supply concerns and nursing difficulties.

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Section: Discussionmentioning

confidence: 79%

Breastfeeding Continuation Among Late Preterm Infants: Barriers, Facilitators, and Any Association With NICU Admission?

Kair

Colaizy

2016

Hospital Pediatrics

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“…Many studies of newborn rehospitalization have focused on subgroups of infants, including term, 7 early term, 12 late preterm, 1 and those with congenital heart disease 11 or hyperbilirubinemia.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Limiting analysis of hospitalization and emergency department (ED) visits to 30 days will not capture potentially important episodes of infant health care utilization that occur after this time period. During the first year of life, 4.4% to 9.5% of term infants are rehospitalized, with Medicaid patients being at increased risk compared with those with private insurance.…”

mentioning

confidence: 99%

“…Common conditions leading to early newborn rehospitalization identified in previous studies include jaundice, feeding issues, and infection. 1,6,7 Risk factors associated with newborn rehospitalization vary and include low gestational age, NICU stay, 8 and bronchopulmonary dysplasia. 9 The causes of newborn rehospitalization may be contextual based on discharge policies, systems of care, and social determinants.…”

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confidence: 99%

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Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

Paul

Agiro

Hoffman

et al. 2016

Hospital Pediatrics

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A B S T R A C T BACKGROUND AND OBJECTIVE:In the first year of life, the rate of rehospitalization for infants has been shown to be between 4.4% and 9.5%. Reducing avoidable health care utilization is a population health priority. The goal of this study was to identify maternal and infant factors associated with rehospitalization and emergency department (ED) utilization in a cohort of newborn Medicaid recipients. METHODS:A longitudinal database was created by linking mother-infant dyads giving birth at a regional perinatal referral center with Delaware state Medicaid data. Multivariable logistic regression and negative binomial regression were used to examine inpatient hospitalization and ED utilization within 6 months after birth. RESULTS:The study cohort included 4112 infants; 452 (11.0%) were rehospitalized, and 1680 (41%) used the CONCLUSIONS:In this newborn Medicaid population, multiple maternal factors (including age, race, and mental health diagnoses) were associated with health care utilization in the 6 months after initial hospital discharge. Our data provide potential risk factors for targeted intervention and suggest that maternal factors should be considered in identifying a population at risk for rehospitalization and ED utilization.

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“…Preterm births affect approximately 9% of live births in Europe (1), that nevertheless have substantial repercussions for a newborns' short and long term health outcomes, as well as for health systems and wider society (2)(3)(4) . In this context, unplanned hospitalisations can be useful markers for serious pathologies, and also represent potentially modifiable adverse events.…”

Section: Introductionmentioning

confidence: 99%

Assessing the risk of early unplanned rehospitalisation in preterm babies: EPIPAGE 2 study

Reed

Morgan²,

Zeitlin

et al. 2019

Preprint

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Background Gaining a better understanding of the probability, timing and prediction of rehospitalisation amongst preterm babies could help improve outcomes. There is limited research addressing these topics amongst extremely and very preterm babies. In this context, unplanned rehospitalisations constitute an important, potentially modifiable adverse event. We aimed to establish the probability, time-distribution and predictability of unplanned rehospitalisation within 30 days of discharge in a population of French preterm babies.Methods This study used data from EPIPAGE 2, a population-based prospective study of French preterm babies. Only those babies discharged home alive and whose parents responded to the 1-year survey were eligible for inclusion in our study. For Kaplan-Meier analysis, the outcome was unplanned rehospitalisation censored at 30 days. For predictive modelling, the outcome was binary, recording unplanned rehospitalisation within 30 days of discharge. Predictors included routine clinical variables selected based on expert opinion.Results Of 3,841 eligible babies, 350 (9.1%, 95% CI 8.2-10.1) experienced an unplanned rehospitalisation within 30 days. The probability of rehospitalisation progressed at a consistent rate over the 30 days. There were significant differences in rehospitalisation probability by gestational age. The cross-validated performance of a ten predictor model demonstrated low discrimination and calibration. The area under the receiver operating characteristic curve was 0.62 (95% CI 0.59-0.65).Conclusions Unplanned rehospitalisation within 30 days of discharge was infrequent and the probability of rehospitalisation progressed at a consistent rate. Lower gestational age increased the probability of rehospitalisation. Predictive models comprised of clinically important variables had limited predictive ability.

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Factors Associated With Readmission in Late-Preterm Infants: A Matched Case-Control Study

Abstract: Infants born via cesarean delivery with longer length of hospital stay have a decreased risk for readmission. As hospitals implement protocols to standardize length of stay, mode of delivery may be a useful factor to identify late-preterm infants at higher risk for readmission.

Cited by 22 publications

References 25 publications

Breastfeeding Continuation Among Late Preterm Infants: Barriers, Facilitators, and Any Association With NICU Admission?

Breastfeeding Continuation Among Late Preterm Infants: Barriers, Facilitators, and Any Association With NICU Admission?

Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

Assessing the risk of early unplanned rehospitalisation in preterm babies: EPIPAGE 2 study

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