Abstract

NAVARRO, E et al. Hospital readmissions in newborns released from joint lodging to home. Rev. bol. ped. [online]. 2008, vol.47, n.1, pp.46-52. ISSN 1024-0675.

Introduction: Readmissions in newborns are an important problem, with significant mortality and costly responsibility. These are a particular challenge to pediatricians, because of the non-specificity and lability of neonatal reactions to different conditions, and the variety of diseases that may present very similarly. Objective: To find the causes of readmission, perinatal characteristics and morbidity and mortality in a population of newborns readmitted during the first month of life, and to analyze possible strategies to improve healthcare for the mother and the newborn in joint lodging. Materials and methods: This was a prospective, observational, analytical study including all newborns released from the joint lodging service and readmitted to the Neonatology Department of the Centro Materno Infantil (San Lorenzo), in the first 28 days of life, between January 2004 and June 2005. Results: A total of 51 newborns were readmitted. Average maternal age was 24 (range 16-41), 76% had insufficient prenatal check-ups and 30% had just enough (4). Fifty seven percent were gesta 0, 20% gesta 1, and 52% of newborns were delivered by C-section. Average birth weight was 3189g (SD ± 593). Average gestational age was 38 weeks (SD ± 2), 41% were near term and borderline (35-37 weeks). Sixty three percent were male, and 100% had and Apgar of 8, 9. Average age on release was 3 days ± 1, all with exclusive breast feeding. Average age on readmission was 9.3 ± 4. Main diagnoses were hyperbillirrubinemia 59%, 90% of which without incompatibility but without hemolysis, 99% required luminotherapy and one patient required exsanguination/transfusion. Eighteen percent were readmitted for defective feding technique, 16% (8) with a diagnosis of major congenital malformations, two patients died, making up 3.9% of the total. Conclusions: The causes of readmission to hospital in this group of newborns was hyperbillirubinemia and defective feeding technique. The severity of readmission was associated with the diagnosis of infections and congenital malformations.

Keywords : readmission; joint lodging; morbidity and mortality; newborn.

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