Why Are Newborns Brought to the Emergency Department?

Ferreira, Helena; Ferreira, Carla; Tavares, Cláudia Mara de Melo; Aguiar, Isolina

doi:10.1097/pec.0000000000001680

Cited by 11 publications

(18 citation statements)

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“…Lower level of maternal education was independently associated with emergency room use for infants, though not with rehospitalization. Prior studies have demonstrated that socioeconomically disenfranchised groups are more likely to seek care for nonurgent medical problems in emergency rooms because of the lack of knowledge about appropriate use of emergency care, lack of health insurance, and/or access to timely outpatient care 26,27 …”

Section: Discussionmentioning

confidence: 99%

Risk factors for emergency room use and rehospitalization among opioid‐exposed newborns in Massachusetts

Hwang

Liu

et al. 2020

Birth

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Objective To determine the risk factors for receipt of emergency room (ER) care and rehospitalization among opioid‐exposed newborns in Massachusetts. Design/Methods We analyzed two linked data sets from 2002 to 2010: (a) Massachusetts Pregnancy to Early Life Longitudinal Data System and (b) Massachusetts Bureau of Substance Abuse Services Management Information System. Generalized estimating equations were used to assess the independent association of maternal and infant characteristics with ER use and rehospitalization in the first year of life. Results Four thousand and five hundred and twenty‐four maternal‐infant dyads affected by OUD were included in the analysis. In adjusted analysis, risk factors for receipt of ER care included Hispanic ethnicity (aOR 1.63 [95% CI 1.30‐2.05]), lower education levels (aOR 1.54‐1.69 [95% CI 1.12‐2.31]), nonprivate insurance (aOR 1.44 [95% CI 1.11‐1.86]), and presence of maternal chronic conditions (aOR 1.14 [95% CI 1.01‐1.29]). Risk factors for rehospitalization included prematurity (aOR 1.44 [95% CI 1.14‐1.82]), low birthweight (aOR 2.02 [95% CI 1.63‐2.49]), and nonprivate insurance (aOR 1.58 [95% CI 1.13‐2.22]). Prolonged infant birth hospitalization was protective against both ER use (aOR 0.84 [95% CI 0.73‐0.96]) and rehospitalization (aOR 0.63 [95% CI 0.53‐0.75]). Conclusions Clinical and sociodemographic characteristics are risk factors for receipt of ER care and rehospitalization among opioid‐exposed newborns in Massachusetts.

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Section: Discussionmentioning

confidence: 99%

Risk factors for emergency room use and rehospitalization among opioid‐exposed newborns in Massachusetts

Hwang

Liu

et al. 2020

Birth

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“…(5) However most studies to date are limited by small numbers, and their applicability to our setting is unknown. (7) In Europe (8)(9)(10) and North America (5,11), up to one-third of neonates attending EDs have no medical issue, and a high proportion have low acuity problems requiring no medical investigation or treatment. Parents prefer to bring their children to either general (12) or paediatric (13) EDs, even with non-urgent problems, for reasons including parental anxiety, perceived advantages of EDs (resources and expertise), and convenience.…”

Section: Introductionmentioning

confidence: 99%

Neonatal Presentations to the Children’s Emergency Department

Blakey

Lyttle²,

Magnus³

2020

Preprint

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Background Paediatric attendances to Emergency Departments (EDs) in the UK are increasing, particularly for younger children. Neonates present a challenge due to their non-specific presentations. Community services are under increasing pressure and parents may preferentially bring their children to the ED, even for non-urgent problems. Neonatal attendances have not been extensively studied, but previous reviews have shown many are well, often not requiring specific medical intervention. This study aimed to characterise the presenting features, management and disposition of neonatal attendances to a tertiary Children's ED (CED). Methods Retrospective observational review of medical records identified via the ED Electronic database of neonatal attendances (<28 days) to Bristol Royal Hospital for Children (BRHC) over 12 months (01/01/2016-31/12/2016). Further information was obtained from investigation results, discharge summaries and historical admissions data. Results Neonatal attendances increased from 655 to 1205 from 2008-2016. The most common presenting complaints were breathing difficulty (18.1%), vomiting (8.3%) and poor feeding (8.2%). The most common diagnoses were "no significant medical problem" (41.9%), bronchiolitis (10.5%) and suspected sepsis (10.0%). Just over 1/3 were admitted (23% inpatient, 12% Short Stay Unit). Median length of stay for inpatients was 2 days. Half of neonatal attendances to the ED had no investigations performed and most (77.7%) needed advice or observation only. Conclusion Many neonates presenting to the CED were well and discharged with observation only. This suggests not only that there is potential for improved community management but that increased support for community colleagues and new parents is needed. There are also implications for reviewing training in emergency medicine, especially the ability to assess "well" infants and to manage common neonatal problems. Drivers of health policy should consider developing enhanced models of out of hospital care which are acceptable to clinicians and families

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“…Millar (4) Londres, 2000 165.000 -2.750 Pérez Solís (2) Oviedo, 2000 21.258 --Pomerantz (23) Ohio, 2002 NR --Madden (26) Boston, 2002 NR --Jain (20) Atlanta, 2006 122585 --Fernández (27) Barcelona, 2006 77000 --Calado (10) Faro, 2009 36121 --Lara (5) Chile, 2014 24.531 --Lee (7) California, 2014 320540 -26711…”

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“…Batu (13) Ankara, 2014 28389 --Richier (11) Francia, 2015 23812 --Alfaro (8) Fuenlabrada, 2017 NR --Fornes (xx) Denia, 2017 8893 --Ijaz (12) Karachi, 2018 3115 --Ferreira (9 ) Guimaraes Casi dos neonatos de cada diez que nacen en nuestra maternidad acabará acudiendo cada año al SUP, valores no exagerados y semejantes a las comunicadas por otros países como USA (7) y España (8). Los neonatos suponen por otra parte solo un porcentaje pequeño del total de niños que acuden al SUP, aunque estas cifras son muy variadas según las características sociosanitarias y hospitalarias de cada país; las nuestras se asemejan a las de España ( 9), Portugal (10,11) y Francia ( 12) y se alejan de países como Pakistán y Turquía (5,13,14).…”

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“…Al igual que otros autores hemos observado una clarísima preponderancia de visitas motu proprio al SUP (sin una visita previa a su pediatra o médico de familia). Se trata de un problema generalizado en España (3,9,(15)(16)(17)(18), Portugal (10,11) y otros países (4,12). Pensamos que estas visitas autodecididas impiden que la atención primaria actúe como acceso controlado al sistema sanitario y suponen una sobrecarga de los servicios de urgencia pediátricos (15,(17)(18)(19)(20).…”

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For which reasons are newborns brought to the emergency department?

et al. 2021

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Objectives: Compare what sanitary and socio-demographic factors present the newborns that were attended in the hospital emergency room in regard to the newborns who don’t visit the hospital during their first month of life. Methods: A retrospective observational case-control study was performed, considering as cases those neonates who were brought to the hospital emergency department during their first month of life, matched with control of their same sex and age, born in the hospital but that hadn’t visited the emergency room. Results: 15.15% of the newborns were brought to the hospital emergency department during the year of the study. The main risk factors associated with the visits to the emergency room were: Unemployment, self-employment, and the mother’s younger age. The main reasons why the newborns were brought were: Phisiological phenomena of the newborn (17.4%), upper respiratory infection (13.4%), and colic or crying (12.8%). Conclusions: Newborns can manifest a wide variety of symptoms and signs that, due to their non-specificity, generate anxiety in their parents and can generate numerous visits to the emergency services, with a higher probability of hospitalization due to their young age and the physician’s caution, rather than due to severity of the illness.

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Why Are Newborns Brought to the Emergency Department?

Cited by 11 publications

References 11 publications

Risk factors for emergency room use and rehospitalization among opioid‐exposed newborns in Massachusetts

Risk factors for emergency room use and rehospitalization among opioid‐exposed newborns in Massachusetts

Neonatal Presentations to the Children’s Emergency Department

For which reasons are newborns brought to the emergency department?

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