[Early discharge of newborns: what problems should we anticipate?].
BACKGROUND
Following Nordic and Anglo-Saxon countries, France is directing towards an early discharge policy from maternity hospitals. French National Authority for Health has published recommendations focusing on the importance to highlight the dangers of such a policy so as to be able to anticipate them.


OBJECTIVE
To describe the complications diagnosed in the newborn infants from day 2 to the current hospital's discharge (noteworthy, if infants are discharged early, these complications may occur at home) to determine predictive factors and to validate those proposed by the French National Authority for Health.


METHODS
Prospective study conducted in the maternity ward of Nancy's level III facility, from January 6th to May 6th 2005.


RESULTS
Nine hundred and three newborn infants were included. Forty-two (4.6%) presented with complications diagnosed from day 2 to hospital's discharge, among which 4 required urgent neonatal care. The most frequent complication was hyperbilirubinemia: 23 newborns were treated with phototherapy between day 2 and day 10. Statistically significant risk factors of hyperbilirubinemia after day 2 in multivariate analysis were instrumental vaginal delivery (OR=2.94; CI 95% [1.04-8.34]) and jaundice before day 2 (OR=7.39; CI 95% [2.66-20.55]). According to the French National Authority for Health's policy, 33 among 42 infants presenting with a complication would have been withdrawn from an early discharge program.


CONCLUSIONS
In our population, French National Authority for Health's recommendations were relevant to guide an early discharge project.
Straczek
H
H
Maternité régionale, Nancy université, 10, rue du Docteur-Heydenreich, 54042 Nancy, France.
Vieux
R
R
Hubert
C
C
Miton
A
A
Hascoet
J-M
JM
D005260:Female; D005602:France / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000628:therapy; D008297:Male; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors