| s obstetrical lengths of stay in North America continue to decrease, it is timely to more closely examine issues of neonatal morbidity. Costs saved in decreasing the hospital length of stay must be examined in light of costs incurred in personal trauma and technical care needed by the newborn readmitted to hospital. Over the past five years, increases have been noted in readmission rates for newborns under two weeks of age, who had been previously discharged as healthy from the obstetrical hospital. The purpose of this study was to determine maternal, infant and environmental variables as identified in Barnard's (1978) model of child development and relate them to the readmission of previously healthy newborns for hyperbilirubinemia, with the intent to effect early identification of at risk groups and change in support services.;A case control design was used to compare risk factors identified in readmitted neonates with two matched control subjects per case. Newborns admitted to the neonatal and general pediatric units at eight participating hospitals over a five month period were included as case subjects in the study (n = 60). Data was obtained from chart reviews at that time regarding their readmission and obstetrical course, and interviews with the mothers addressed issues of maternal competence. Control subjects were matched with case subjects on hospital of birth and parity of the mother with similar data being obtained from chart reviews and maternal interviews (n = 120).;The interviews were subject to content analysis with subsequent categorization and coding. Chi-square analysis of the two groups on variables of interest revealed male, firstborn infants born to Oriental mothers are at higher risk for hyperbilirubinemia. Breastfed newborns born vaginally, and discharged ;In the Metropolitan Toronto region, earlier newborn discharge can have adverse effects when care of the mother-infant dyad is not individualized. Causes of readmission of a newborn... |
