NSW Mothers Are Getting Older And Babies Are Staying Away From Hospital: Medical Journal Of Australia

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The number of babies being readmitted to hospital in their first year of life has decreased by more than 10% in New South Wales, according to research published in the Medical Journal of Australia.

Samantha Lain, a research fellow at the University of Sydney’s Kolling Institute, and her coauthors used data for all live births in NSW between January 2001 and December 2009 to determine the number of infants readmitted to hospital at least once in their first year and any changes in maternal and infant risk factors.

Readmissions of infants dropped from 18.4 per 100 births in 2001 to 16.5 in 2009, a relative reduction of 10.5%.

They also found that:

  • The proportion of mothers over the age of 35 years increased to 24% from 18%
  • Mothers who smoked decreased to 12% from 17%
  • The proportion of infants discharged in the first two days after birth increased to 36% from 28%
  • Infants staying in hospital for 5 days or longer decreased to 23% from 33%.

The most commonly diagnosed conditions which showed a significant decrease in the rate of readmissions were upper respiratory tract infections (down 1.6% per year), intestinal infectious diseases (down 3.2% per year), and viral infections (down 3.2%).

Hospital readmissions for jaundice and feeding problems increased by 8.1% and 3.5% respectively.

The authors found two trends may influence these changes.

An increase in the proportion of infants discharged from hospital in the first two days after birth and an “increase in the rate of infants born late preterm (34–36 weeks) and early term (37–38 weeks)”. These infants have an increased risk of admission to hospital for jaundice and feeding difficulties.

“Over half of the total decrease [in hospital readmissions] can be explained by changes in the frequency of maternal and infant risk factors, predominantly a decrease in the length of stay at birth, an increase in maternal age and a decrease in maternal smoking,” the authors write.

Some of the unexplained decline in hospital readmissions may be attributable to policy changes.

An emphasis on early antenatal visits in NSW from 2003 may have influenced the decrease in the numbers of mothers smoking during pregnancy.

And the Early Postnatal Discharge program, introduced in the 1980s, and the Midwifery Support Program, which provided follow-up care post-discharge, may also have had an effect.

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