Maternity care options influence readmission of newborns.

AIM: To analyse morbidity and mortality in healthy newborn infants in relation to various routines of post-natal follow-up.

DESIGN

cross-sectional study.

SETTING

maternity care in Sweden.

POPULATION: healthy infants born at term between 1999 and 2002 (n = 197,898).

METHODS

Assessment of post-natal follow-up routines after uncomplicated childbirth in 48 hospitals and data collected from the Swedish Medical Birth Register, Hospital Discharge Register and Cause-of-Death Register.

MAIN OUTCOME MEASURE: neonatal mortality and readmission as proxy for morbidity.

RESULTS

During the first 28 days, 2.1% of the infants were readmitted generally because of infections, jaundice and feeding-related problems. Infants born in hospitals with a routine neonatal examination before 48 h and a home care programme had a readmission rate [OR, 1.3 (95% CI, 1.16-1.48)] higher than infants born in hospitals with routine neonatal examination after 48 h and 24-h care. There were 26 neonatal deaths.

CONCLUSION

Post-delivery care options and routines influence neonatal morbidity as measured by hospital readmission rate. A final infant examination at 49-72 h and an active follow-up programme may reduce the risk of readmission.