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ORIGINAL RESEARCH |
From the RAND Corporation, Santa Monica; and the Department of Obstetrics and Gynecology, UCLA School of Medicine, Los Angeles, California.
Address reprint requests to: Jesse D. Malkin, PhD Covance Health Economics and Outcomes Services, Inc. 1100 New York Avenue, NW Suite 200 East Washington, DC 20005 E-mail: jesse.malkin{at}covance.com
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.
Conclusion: Newborns discharged within 30 hours of birth are at increased risk of death within the first year of life.
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