July 23, 1997 in Nation/World

‘Drive-Through’ Births Criticized Early Discharge Of New Mothers Increases Chance Of Clinical Problems, UW Study Finds

Newsday
 

Newborns discharged from the hospital after so-called “drive-through” deliveries are more likely to return to the hospital for treatment than infants who are allowed longer stays, according to a new study.

The findings add fodder to the often raucous debate between insurers and health care advocates about how the length of a hospital stay affects the well-being of newborns.

Researchers at the University of Washington found that infants discharged within 30 hours of birth were more likely to be readmitted for jaundice, dehydration and infections than infants allowed longer stays.

“I am a pediatrician, and I certainly have been seeing clinical problems associated with early discharge,” said Dr. Lenna Liu, lead investigator of the study, which is to appear in today’s Journal of the American Medical Association.

In addition to newborns’ medical problems, Liu also found that some women, particularly first-time mothers, had trouble breast-feeding, which added to the stress of caring for an infant - and often prompted a return to the hospital for the baby.

Liu and her team estimate that eight of every 100 rehospitalizations of newborns, during the first week of life, may be linked to early discharge. Jaundice, a common problem in newborns, takes about three days to fully manifest, Liu explained, which means that affected babies are at home and away from medical care by the time parents are aware of the condition.

“I don’t think that there is any way that you can mandate a certain number of hours for every newborn,” Liu added.

“The length of the stay should be a mutual decision between the family and their health care provider.”

But the findings nevertheless support legislation signed by President Clinton, Liu said, calling for a minimum 48-hour hospital stay covered by insurance.

About 17 percent of the 310,578 newborns studied by Liu and her colleagues were released within 30 hours of birth. Of those babies, 6,444 developed problems significant enough to require rehospitalization.

The likelihood of returning to the hospital increased, the study showed, as time wore on during the first weeks of life.


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