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Early Discharge of Preterm Infants- An Indian Perspective
Ankit Soni1, Sandeep Kadam2, Anand Pandit3
1Resident, Division of Neonatology, Department of Paediatrics, King Edward Memorial Hospital , Pune, India .
Insights
Early home discharge for preterm infants born before 34 weeks gestation is feasible and safe. This study found no re-admissions or mortality in the earliest preterm group after early discharge.
Area of Science:
- Neonatal care
- Pediatric outcomes
- Public health policy
Background:
- Early home discharge for preterm infants is crucial in developing nations due to resource limitations.
- Optimal discharge timing for preterm infants remains understudied, impacting clinical practice and policy.
- Socio-economic and medico-legal factors necessitate evaluating early discharge outcomes.
Purpose of the Study:
- To assess re-admission and mortality rates within four weeks post-discharge for preterm infants born before 34 weeks gestation.
- To evaluate the safety and feasibility of early home discharge protocols for preterm neonates.
- To inform clinical practice regarding the discharge timing of preterm infants.
Main Methods:
- Retrospective analysis of preterm infants (gestation <34 weeks) discharged from a Neonatal Intensive Care Unit (NICU).
- Infants stratified into two groups: Group I (26-29 weeks) and Group II (30-34 weeks).
- Data collected on demographics, hospital course, and post-discharge outcomes, focusing on re-admission/mortality within 4 weeks.
Main Results:
- Mean length of stay was significantly longer for Group I (42 days) compared to Group II (19 days).
- No infants in Group I experienced re-admission or mortality within four weeks post-discharge.
- A 2.7% re-admission rate was observed in Group II within the first four weeks.
Conclusions:
- Early home discharge for preterm infants (<34 weeks gestation) is a feasible and safe practice within this healthcare setting.
- The findings support the safety of early discharge for carefully selected preterm infants.
- Further large-scale prospective studies are recommended to validate these benefits and refine discharge guidelines.
Introduction:
Early home discharge of preterm infants is a priority in developing countries due to bed shortage and poor socio-economic status. There is wide variation in home discharge policies for preterm infants. Limited data exists on optimal timing for discharging such infants. In view of the socio-economic and medico-legal importance of the issue, we aimed to study the outcomes of our ex-preterm infants discharged home 'early', to guide our clinical practice.
Aim:
To study the rates of re-admissions/mortality within 4 weeks after discharge in preterm (born <34 weeks) infants.
Materials And Methods:
This was an analysis of retrospectively collected data on all ex-preterm infants (gestation <34 weeks at birth) discharged home from our Neonatal Intensive Care Unit (NICU) during the study period. Infants enrolled were stratified based on their gestation age: Group I (n=54): 26-29 weeks, Group II (n=181): 30-34 weeks. Data on demographic characteristics, hospital course and outcomes were analysed for infants meeting inclusion criteria. Re-admission and/or mortality within 4 weeks after discharge were studied.
Results:
The mean±(SD) duration of stay was 42±19 vs. 19±14 days in group I vs. II infants. Five (2.7%) infants were re-admitted within the first four weeks after discharge in group II; none in group I.
Conclusion:
Early home discharge for preterm infants born <34 weeks was feasible and safe in our set-up. Large prospective studies are required to confirm these benefits.
