Ricerca
Dimissione appropriata del neonato sano
EARLY DISCHARGE OF THE NEWBORN BABY
GIUSEPPE LA GAMBA1, GHERARDO RAPISARDI2
1Divisione di Patologia Neonatale, Azienda Ospedaliera “Pugliese - Ciaccio”, Catanzaro
2T.I.N. - Cattedra di Pediatria Preventiva e Sociale, Azienda Ospedaliera “Meyer”, Firenze
Novembre 1999 - pagg. 574 -578
Abstract
The Authors discuss risks and negative side effects of early discharge of the newborn baby.
Studies carried out in USA show that less than 3% of babies who had been discharged witin
24-48 hours needed to be readmitted. Most of the readmissions were due to jaundice, a
few to dehydration, nutritional problems and previously undiagnosed congenital anomalies.
The concept of early discharge should be reconsidered, however, since the widely perceived
need is a timing of discharge suited to the mother’s and baby’s conditions and a
postnatal domiciliary care and support. Several pilot projects have been started based on
these principles and guidelines have been recently established for health service
networking.
Classificazione MeSH
Bibliografia
1. Marbella JAM, et al: Neonatal hospital lenght
of stay. Reammission and charges. Pediatrics
101, 32, 1998.
2. Biasini GC, Bianchi D, Fellini D: La dimissione precoce: consente un risparmio di risorse? Quaderni ACP 6, 10, 1999.
3. Baronciani D, Bellù R, Zanini R: I tre paradossi della dimissione precoce. Medico e Bambino vol. 18, 3, 181, 184, 1999.
4. CDC: Trends in length of stay for hospital deliveries – U.S., 1970-1992. MMWR 44, 335, 1995.
5. Arthurton MW, Bamford FN: Paediatric aspects of the early discharge of maternity patients. BMJ 3, 517, 1997.
6. Braveman P, et al: Early discharge and evidence-based practice: Good science and good judgment. JAMA 278, 334, 1997.
7. Eidelman AI, et al: Maternal cognitive deficits and early discharge of infants. Pediatrics 98, 516, 1996.
8. Kessel W, et al: Early discharge: in the end, it is judgment. Pediatrics 96, 739, 1995.
9. McCabe ERB, et al: Newborn screening, phenylketonuria: predictive validity as a function of age. Pediatrics 72, 390, 1983.
10. Sinai LN, et al: Phenylketonuria screening: Effects of early newborn discharge. Pediatrics 96, 605, 1995.
11. Catz C, et al: Early discharge and neonatal hyperbilirubinemia. Pediatrics 96, 743, 1995.
12. Burnell I, et al: Patient preference and postnatal hospital stay. Am J Obstet Gycol 3, 43, 1982.
13. Hellman LM, et al: Early hospital discharge in obstetrics. Lancet 1, 227, 1962.
14. Morrow AL, et al: Efficacy of home-based peer counselling to promote exclusive breastfeeding: a randomized controlled trial. BMJ vol. 353, n. 9, 160, 1999.
15. Moss G, et al: Routine examination in the neonatal period. BMJ 302, 878, 1991.
16. Conrad PD, et al: Safety of newborn discharge in less than 36 hours in an indigent population. Am J Dis Child 143, 98, 1989.
17. Liu LL, et al: The safety of newborn early discharge: The Washington state experience. JAMA 278, 293, 1997.
18. Lee KS, et al: Association between of neonatal hospital stay and readmission. J Pediatr 127, 758, 1995.
19. Edmonson MB, et al: Hospital riammission with feeding-related problems after early postpartum discharge of normal newborn. JAMA 299, 303, 1997.
20. Cooper W, et al: Increased incidence of severe breastfeeding malnutrition and hypernatriemia in a metropolitan area. Pediatrics vol. 96, n. 5, 957, 1995.
21. Maisels MJ, Kring E: Length of stay, jandice and hospital riammission. Pediatrics 995, 998, 1998.
22. A joint statement with the Society of Obstetricians and Gynaecologists of Canada and Canadian Pediatric Society: Facilitating discharge home following a normal term birth. Pediatric & Child Health 1(2), 165-8, 1996.
23. Kiely M, Drum MA, Kessel W: Early discharge: Risks, Benefits, Who decides. Clin In Perin 3, 539, 1998.
24. Brooten D, et al: Functions of CNS in early discharge and home follow up of every low birth weight infants. Clin Nurse Spec 5, 196, 1991.
25. Olds DL, Kitzman H: Can home visitation improve the healthof women and children at envirnmental risk? Pediatrics 86, 108, 1989.
26. Braveman P, et al: Early discharge of newborns and mothers: A critical review of the literature. Pediatrics 96, 716, 1995.
27. Odelram H, et al: Early discharge after delivery, a safe and cost effective form of care. Lakartidningen 95, 3, 190, 1998.
28. Mandruzzato GP, et al: Epidemiologia del taglio cesareo. Nascere n. 31, 1999.
2. Biasini GC, Bianchi D, Fellini D: La dimissione precoce: consente un risparmio di risorse? Quaderni ACP 6, 10, 1999.
3. Baronciani D, Bellù R, Zanini R: I tre paradossi della dimissione precoce. Medico e Bambino vol. 18, 3, 181, 184, 1999.
4. CDC: Trends in length of stay for hospital deliveries – U.S., 1970-1992. MMWR 44, 335, 1995.
5. Arthurton MW, Bamford FN: Paediatric aspects of the early discharge of maternity patients. BMJ 3, 517, 1997.
6. Braveman P, et al: Early discharge and evidence-based practice: Good science and good judgment. JAMA 278, 334, 1997.
7. Eidelman AI, et al: Maternal cognitive deficits and early discharge of infants. Pediatrics 98, 516, 1996.
8. Kessel W, et al: Early discharge: in the end, it is judgment. Pediatrics 96, 739, 1995.
9. McCabe ERB, et al: Newborn screening, phenylketonuria: predictive validity as a function of age. Pediatrics 72, 390, 1983.
10. Sinai LN, et al: Phenylketonuria screening: Effects of early newborn discharge. Pediatrics 96, 605, 1995.
11. Catz C, et al: Early discharge and neonatal hyperbilirubinemia. Pediatrics 96, 743, 1995.
12. Burnell I, et al: Patient preference and postnatal hospital stay. Am J Obstet Gycol 3, 43, 1982.
13. Hellman LM, et al: Early hospital discharge in obstetrics. Lancet 1, 227, 1962.
14. Morrow AL, et al: Efficacy of home-based peer counselling to promote exclusive breastfeeding: a randomized controlled trial. BMJ vol. 353, n. 9, 160, 1999.
15. Moss G, et al: Routine examination in the neonatal period. BMJ 302, 878, 1991.
16. Conrad PD, et al: Safety of newborn discharge in less than 36 hours in an indigent population. Am J Dis Child 143, 98, 1989.
17. Liu LL, et al: The safety of newborn early discharge: The Washington state experience. JAMA 278, 293, 1997.
18. Lee KS, et al: Association between of neonatal hospital stay and readmission. J Pediatr 127, 758, 1995.
19. Edmonson MB, et al: Hospital riammission with feeding-related problems after early postpartum discharge of normal newborn. JAMA 299, 303, 1997.
20. Cooper W, et al: Increased incidence of severe breastfeeding malnutrition and hypernatriemia in a metropolitan area. Pediatrics vol. 96, n. 5, 957, 1995.
21. Maisels MJ, Kring E: Length of stay, jandice and hospital riammission. Pediatrics 995, 998, 1998.
22. A joint statement with the Society of Obstetricians and Gynaecologists of Canada and Canadian Pediatric Society: Facilitating discharge home following a normal term birth. Pediatric & Child Health 1(2), 165-8, 1996.
23. Kiely M, Drum MA, Kessel W: Early discharge: Risks, Benefits, Who decides. Clin In Perin 3, 539, 1998.
24. Brooten D, et al: Functions of CNS in early discharge and home follow up of every low birth weight infants. Clin Nurse Spec 5, 196, 1991.
25. Olds DL, Kitzman H: Can home visitation improve the healthof women and children at envirnmental risk? Pediatrics 86, 108, 1989.
26. Braveman P, et al: Early discharge of newborns and mothers: A critical review of the literature. Pediatrics 96, 716, 1995.
27. Odelram H, et al: Early discharge after delivery, a safe and cost effective form of care. Lakartidningen 95, 3, 190, 1998.
28. Mandruzzato GP, et al: Epidemiologia del taglio cesareo. Nascere n. 31, 1999.