Predictors of hospital readmission of Manitoba newborns within six weeks postbirth discharge: a population-based study
Related Experiment Video
Updated: Aug 22, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Patricia J Martens1, Shelley Derksen, Sumit Gupta
1Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. pat_martens@cpe.umanitoba.ca
Insights
Infant hospital readmissions within 6 weeks of discharge were associated with lower income and geographic location. Modifiable factors like breastfeeding and cesarean rates require further study for causation.
Area of Science:
- Pediatrics
- Public Health
- Health Services Research
Background:
- Infant hospital readmissions are a significant concern in healthcare.
- Understanding the predictors and geographic variations of these readmissions is crucial for targeted interventions.
Purpose of the Study:
- To determine the rate of infant hospital readmissions within six weeks post-discharge.
- To identify individual and geographic factors associated with these readmissions.
- To explore the correlation between regional readmission rates and health/socioeconomic status.
Main Methods:
- A population-based, cross-sectional study analyzed 68,681 infant hospital discharge records in Manitoba, Canada (1997-2001).
- Logistic regression identified predictors of readmission, including prematurity, birth weight, income, geography, breastfeeding, maternal age, and delivery type.
- Ecologic correlations examined the relationship between regional readmission rates and premature mortality rates (PMR) and socioeconomic factors (SEFI).
Main Results:
- The overall infant readmission rate was 3.95%, with respiratory illness being the most common cause.
- Higher readmission risk was observed for preterm infants, those from lower income quintiles, and residents of northern or rural southern regions.
- Not breastfeeding, younger maternal age (≤19 years), and cesarean delivery were also associated with increased readmission risk.
Conclusions:
- Lower income and geographic location are significant predictors of infant hospital readmission.
- While breastfeeding, cesarean section, and adolescent pregnancy rates are potentially modifiable risk factors, further research is needed to establish causality.
Objectives:
To examine the proportion, geographic variation, and predictors of infant hospital readmission within 6 weeks of the postbirth discharge.
Methods:
A cross-sectional, population-based study was conducted of all infants who were born from 1997 through 2001, linkable to the birth mother, and discharged alive from the hospital (N = 68 681) using hospital discharge files in the Canadian province of Manitoba. The following predictors of readmission were examined using logistic regression: preterm, low birth weight, neighborhood income, geographic location (the North, Rural South, and Urban areas of Winnipeg and Brandon), breastfeeding status, length of stay, maternal age, and type of delivery. Using 9 non-Winnipeg regions and 12 Winnipeg subregions, ecologic correlations (1-tailed Spearman) between newborn hospital readmission rates and the following were examined: 1) a region's overall health status, measured by the premature mortality rate (PMR), or death before aged 75 years and 2) a region's socioeconomic risk, using the Socio-Economic Factor Index (SEFI).
Results:
The proportion of infants who were readmitted to the hospital at least once within 6 weeks of postbirth hospital discharge was 3.95%, with respiratory illness the leading cause (22.3% of readmissions). Risk of readmission was higher for infants who were born preterm (adjusted odds ratio [AOR]: 1.80; 95% confidence interval [CI]: 1.55-2.10), who were of the 3 lowest income quintiles (lowest: AOR: 2.02; 95% CI: 1.77-2.32; low: AOR: 1.48; 95% CI: 1.29-1.71; middle: AOR: 1.26; 95% CI: 1.08-1.47), who resided in the North (AOR: 1.85; 95% CI: 1.66-2.07) or Rural South (AOR: 1.25; 95% CI: 1.14-1.36), who were not breastfed (AOR: 1.32; 95% CI: 1.20-1.44), whose mother's age was 17 or younger (AOR: 1.30; 95% CI: 1.10-1.55), whose mother was 18 to 19 years of age (AOR: 1.25; 95% CI: 1.09-144), or who were born by cesarean section (AOR: 1.30; 95% CI: 1.19-1.43). Regional readmission rates were correlated with PMR (9 non-Winnipeg regions: r = 0.77 for PMR and r = 0.68 for SEFI; 12 Winnipeg Community Areas: r = 0.49 for PMR and r = 0.73 for SEFI).
Conclusions:
Income and geography are strongly associated with newborn hospital readmission. Modifiable risk factors include increasing breastfeeding rates, decreasing cesarean section rates, and decreasing adolescent pregnancy rates (or increasing adolescent parental support), but these need additional study to establish causation.