Early Postnatal Care Among Healthy Newborns in 19 States: Pregnancy Risk Assessment Monitoring System, 2000

Overview

Journal Matern Child Health J

Specialty Health Services

Date 2005 Dec 31

PMID 16382330

Citations 7

Authors

Amy Lansky

Wanda D Barfield

Kristen S Marchi

Susan A Egerter

Alison A Galbraith

Paula A Braveman

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Discrimination Predicts Suboptimal Adherence to CPAP Treatment and Mediates Black-White Differences in Use.

Wallace D, Grant A, Belisova-Gyure Z, Ebben M, Bubu O, Johnson D Chest. 2023; 165(2):437-445.

PMID: 37741324 PMC: 10851273. DOI: 10.1016/j.chest.2023.09.016.

Early postnatal discharge from hospital for healthy mothers and term infants.

Jones E, Stewart F, Taylor B, Davis P, Brown S Cochrane Database Syst Rev. 2021; 6:CD002958.

PMID: 34100558 PMC: 8185906. DOI: 10.1002/14651858.CD002958.pub2.

Determinants of length of stay after cesarean sections in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005-2015.

Cegolon L, Mastrangelo G, Maso G, Dal Pozzo G, Heymann W, Ronfani L Sci Rep. 2020; 10(1):19238.

PMID: 33159096 PMC: 7648096. DOI: 10.1038/s41598-020-74161-2.

Determinants of Length of Stay After Vaginal Deliveries in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005-2015.

Cegolon L, Maso G, Heymann W, Bortolotto M, Cegolon A, Mastrangelo G Sci Rep. 2020; 10(1):5912.

PMID: 32249795 PMC: 7136236. DOI: 10.1038/s41598-020-62774-6.

Care Coordination Associated with Improved Timing of Newborn Primary Care Visits.

Goyal N, Hall E, Kahn R, Wexelblatt S, Greenberg J, Samaan Z Matern Child Health J. 2016; 20(9):1923-32.

PMID: 27146395 DOI: 10.1007/s10995-016-2006-0.

References

Maisels M, Kring E . Early discharge from the newborn nursery-effect on scheduling of follow-up visits by pediatricians. Pediatrics. 1997; 100(1):72-4. DOI: 10.1542/peds.100.1.72. View

Braveman P, Egerter S, Pearl M, Marchi K, Miller C . Problems associated with early discharge of newborn infants. Early discharge of newborns and mothers: a critical review of the literature. Pediatrics. 1995; 96(4 Pt 1):716-26. View

Declercq E, Simmes D . The politics of "Drive-through deliveries": putting early postpartum discharge on the legislative agenda. Milbank Q. 1997; 75(2):175-202. PMC: 2751046. DOI: 10.1111/1468-0009.00051. View

Galbraith A, Egerter S, Marchi K, Chavez G, Braveman P . Newborn early discharge revisited: are California newborns receiving recommended postnatal services?. Pediatrics. 2003; 111(2):364-71. DOI: 10.1542/peds.111.2.364. View

Brown S, Small R, Faber B, Krastev A, Davis P . Early postnatal discharge from hospital for healthy mothers and term infants. Cochrane Database Syst Rev. 2002; (3):CD002958. DOI: 10.1002/14651858.CD002958. View

MARGOLIS L, Gay K, Humphrey A . The role of state maternal and child health programs in the issue of newborn discharge. Matern Child Health J. 2000; 2(1):45-54. DOI: 10.1023/a:1021845609606. View

. Hospital stay for healthy term newborns. American Academy of Pediatrics Committee on Fetus and Newborn. Pediatrics. 1995; 96(4 Pt 1):788-90. View

Gilbert B, Shulman H, Fischer L, Rogers M . The Pregnancy Risk Assessment Monitoring System (PRAMS): methods and 1996 response rates from 11 states. Matern Child Health J. 2000; 3(4):199-209. DOI: 10.1023/a:1022325421844. View

Shulman H, Gilbert B, Msphbrenda C, Lansky A . The Pregnancy Risk Assessment Monitoring System (PRAMS): current methods and evaluation of 2001 response rates. Public Health Rep. 2006; 121(1):74-83. PMC: 1497801. DOI: 10.1177/003335490612100114. View

10.

Beck L, Morrow B, Lipscomb L, Johnson C, Gaffield M, Rogers M . Prevalence of selected maternal behaviors and experiences, Pregnancy Risk Assessment Monitoring System (PRAMS), 1999. MMWR Surveill Summ. 2002; 51(2):1-27. View

11.

Madden J, Soumerai S, Lieu T, Mandl K, Zhang F, Ross-Degnan D . Effects of a law against early postpartum discharge on newborn follow-up, adverse events, and HMO expenditures. N Engl J Med. 2002; 347(25):2031-8. DOI: 10.1056/NEJMsa020408. View

12.

Marbella A, Chetty V, Layde P . Neonatal hospital lengths of stay, readmissions, and charges. Pediatrics. 1998; 101(1 Pt 1):32-6. DOI: 10.1542/peds.101.1.32. View

13.

MARGOLIS L . A critical review of studies of newborn discharge timing. Clin Pediatr (Phila). 1995; 34(12):626-34. DOI: 10.1177/000992289503401201. View

14.

Newacheck P, Hughes D, Stoddard J . Children's access to primary care: differences by race, income, and insurance status. Pediatrics. 1996; 97(1):26-32. View

15.

Meara E, Kotagal U, Atherton H, Lieu T . Impact of early newborn discharge legislation and early follow-up visits on infant outcomes in a state Medicaid population. Pediatrics. 2004; 113(6):1619-27. DOI: 10.1542/peds.113.6.1619. View

16.

Grullon K, Grimes D . The safety of early postpartum discharge: a review and critique. Obstet Gynecol. 1997; 90(5):860-5. DOI: 10.1016/S0029-7844(97)00405-5. View

17.

Madlon-Kay D, DeFor T, Egerter S . Newborn length of stay, health care utilization, and the effect of Minnesota legislation. Arch Pediatr Adolesc Med. 2003; 157(6):579-83. DOI: 10.1001/archpedi.157.6.579. View

18.

Lieu T, Wikler C, Capra A, Martin K, Escobar G, Braveman P . Clinical outcomes and maternal perceptions of an updated model of perinatal care. Pediatrics. 1998; 102(6):1437-44. DOI: 10.1542/peds.102.6.1437. View

19.

Eaton A . Early postpartum discharge: recommendations from a preliminary report to Congress. Pediatrics. 2001; 107(2):400-3. DOI: 10.1542/peds.107.2.400. View

20.

Hyman D . What lessons should we learn from drive-through deliveries?. Pediatrics. 2001; 107(2):406-7. DOI: 10.1542/peds.107.2.406. View