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Reingreso hospitalario con problemas relacionados con la alimentación después de la alta posparto temprana de recién
M B Edmonson1, J J Stoddard, L M Owens
1Department of Pediatrics, Center for Health Sciences, University of Wisconsin-Madison, 53792-4116, USA.
JAMA
|July 23, 1997
Resumen
El alta posparto temprana para recién nacidos no aumenta el riesgo de readmisión por problemas de alimentación. Varios factores maternos e infantiles están asociados con la readmisión, pero el tiempo de alta no es un factor de riesgo independiente significativo.
Área de la Ciencia:
- Salud Neonatal La salud neonatal es la salud neonatal.
- Política de salud pública Política de salud pública.
- El cuidado materno-infantil.
Sus antecedentes:
- La Ley de Protección de la Salud de los recién nacidos y las madres de 1996 siguió a un debate político sobre las estancias hospitalarias cortas posparto.
- Este debate carecía de evidencia basada en la población sobre los efectos adversos para la salud del alta temprana de recién nacidos.
Objetivo del estudio:
- Investigar si el alta hospitalaria postparto temprano aumenta el riesgo de readmisión para los recién nacidos normales debido a problemas relacionados con la alimentación.
Principales métodos:
- Un estudio de casos y controles anidados analizó el certificado de nacimiento de Wisconsin y los datos de alta hospitalaria de 1991-1994.
- Se incluyeron 120.290 recién nacidos normales; los casos fueron 210 bebés readmitidos, los controles fueron 630 bebés.
- Los resultados de readmisión se centraron en problemas de alimentación, deshidratación o aumento de peso inadecuado entre los 4 y 28 días de vida.
Principales resultados:
- Las descargas tempranas aumentaron significativamente, pero las readmisiones relacionadas con la alimentación se mantuvieron estables.
- Los bebés readmitidos eran más propensos a ser amamantados, primogénitos, prematuros o tener madres con menor educación, estado soltero o en Medicaid.
- El alta temprana no se asoció de manera independiente con un mayor riesgo de readmisión (aOR 1.05, IC del 95% 0,71-1,53).
Conclusiones:
- Los factores neonatales y maternos están relacionados con un mayor riesgo de readmisión por problemas de alimentación.
- La descarga postparto temprana no parece elevar de manera independiente el riesgo de readmisión por problemas relacionados con la alimentación en recién nacidos por lo demás sanos.
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