Infant mortality and early postpartum discharge.
OBJECTIVE
To assess additional risk of newborn death owing to early discharge.


METHODS
This was a historical cohort study using Washington State linked birth certificates, death certificates, and hospital discharge records that covered 47,879 live births in 1989 and 1990. Logistic regression was used to assess risk of death within the first year of life after early discharge (less than 30 hours after birth) compared with later discharge (30-78 hours after birth).


RESULTS
Newborns discharged early were more likely to die within 28 days of birth (odds ratio [OR] 3.65; 95% confidence interval [CI] 1.56, 8.54), between 29 days and 1 year (OR 1.61; 95% CI 1.10, 2.36), and any time within the first year (OR 1.84; 95% CI, 1.31, 2.60) of life than newborns sent home later. Newborns discharged early also were more likely to die of heart-related problems (OR 3.72; CI 1.25, 11.04) and infections (OR 4.72; CI 1.13, 19.67) within 1 year of birth than newborns discharged later.


CONCLUSIONS
Newborns discharged within 30 hours of birth are at increased risk of death within the first year of life.
Malkin
J D
JD
RAND Corporation, Santa Monica, California, USA. jesse.malkin@covance.com
Garber
S
S
Broder
M S
MS
Keeler
E
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D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data*; D049590:Postpartum Period; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012923:Social Class; D014861:Washington / Q000453:epidemiology