Early postnatal care among healthy newborns in 19 States: pregnancy risk assessment monitoring system, 2000.
OBJECTIVE
To examine early postnatal care among healthy newborns during 2000 in 19 states.


METHODS
Using data from the Pregnancy Risk Assessment Monitoring System, a multistate population-based postpartum survey of women, we calculated prevalences of early discharge (ED; stays of < or =2 days after vaginal delivery and < or =4 days after Cesarean delivery) and early follow-up (within 1 week) after ED. We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) describing how ED and lack of early follow-up were associated with state legislation and maternal characteristics.


RESULTS
While most healthy term newborns (83.5-93.4%) were discharged early, and most early-discharged newborns (51.5-88.5%) received recommended early follow-up, substantial proportions of early-discharged newborns did not. Compared with newborns in states where legislation covered both length of hospital stay (LOS) and follow-up, newborns in states without such legislation were more likely to have ED (aOR: 1.25; CI: 1.01-1.56). Lack of early follow-up was more likely among newborns in states with neither LOS nor follow-up legislation (aOR: 2.70, CI: 2.32-3.14), and only LOS legislation (aOR: 1.38, CI: 1.22-1.56) compared with those in states with legislation for both. ED was more likely among newborns born to multiparous women and those delivered by Cesarean section and less likely among those born to black and Hispanic mothers and mothers with less education.


CONCLUSIONS
Lack of early follow-up among ED newborns remains a problem, particularly in states without relevant legislation. These findings indicate the need for continued monitoring and for programmatic and policy strategies to improve receipt of recommended care.
Lansky
Amy
A
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia 30333, USA.
Barfield
Wanda D
WD
Marchi
Kristen S
KS
Egerter
Susan A
SA
Galbraith
Alison A
AA
Braveman
Paula A
PA
D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D010351:Patient Discharge / Q000331:legislation & jurisprudence; D011181:Postnatal Care; D018570:Risk Assessment / Q000379:methods; D013219:State Government; D014481:United States