Uncovering the Hidden Burden: Neonatal Readmissions at Children Welfare Teaching Hospital
View Article

Keywords

Neonatal
Hospital Readmissions
Readmissions Rate
Causes Of Readmissions

How to Cite

Abdulridha, Y. I., & Ahmed, S. S. (2025). Uncovering the Hidden Burden: Neonatal Readmissions at Children Welfare Teaching Hospital. International Journal of Pediatrics and Genetics , 3(5), 26–38. Retrieved from https://medicaljournals.eu/index.php/IJPG/article/view/1845

Abstract

Background: The neonatal period is important for establishing a strong healthy foundation and is also associated with high mortality and morbidity rates. This study aimed to determine the rate of neonatal hospital readmission and to identify the associations between the neonatal age at readmission and the length of stay (LOS) during readmission, the outcome of readmission, and the associated maternal and neonatal factors.

Aim: to evaluate Neonatal Hospital Readmissions Rate and Associated Causes.

Methods: A prospective study was performed by reviewing the medical cases information by relatives of 120 neonates who were born in and readmitted to Children Welfare Teaching Hospital (CWTH) in Baghdad

Results: The mean age at admission was 16.03 days, with a wide range from 2 to 90 days, indicating variability in the timing of hospital admissions. The mean gestational age was 37 weeks, with a standard deviation of 2.35, suggesting that the majority of neonates were born at or near term. Birth weight exhibited considerable variation, with a mean of 2706.92 grams and a minimum of 300 grams, reflecting the inclusion of both full-term and preterm neonates. Maternal age ranged from 17 to 41 years, with a mean of 26 years, indicating a relatively young maternal population.Among the neonates, 57.5% were male, while 42.5% were female, indicating a slight predominance of male admission. Regarding the mode of delivery, cesarean section (C/S) was the most common method, accounting for 60% of cases, whereas 40% of deliveries were normal vaginal deliveries (NVD). The majority of neonates (95%) were from singleton pregnancies, with only 5% resulting from twin gestations. In terms of feeding practices, bottle feeding was the most prevalent (60%), followed by mixed feeding (33.3%), while exclusive breastfeeding was reported in only 6.7% of cases. Most common cause of readmission was sepsis 31.7%.

Conclusion: Sepsis (31.7%) and jaundice (23.3%) emerged as the primary reasons for neonatal hospital readmissions, closely followed by congenital anomalies (16.7%). These conditions predominantly impacted younger neonates, with sepsis consistently leading across all age groups. A notable neonatal mortality rate of 17.5% underscores the severity of these conditions. However, a majority (74.2%) achieved successful discharge, reflecting effective management and recovery outcomes, though a subset required further specialized care referrals. Significant statistical associations between age groups and causes of readmission emphasize the necessity for tailored, age-specific interventions. Furthermore, the chi-square tests demonstrated statistically significant associations between age and causes of readmission, highlighting the need for age-specific interventions.

View Article

References

1. Pinheiro JM, Tinoco Ldos S, Rocha AS, Rodrigues MP, Lyra Cde O, Ferreira MÂ. Childcare in the neonatal period: Evaluation of neonatal mortality reduction pact in Rio Grande do Norte, Brazil Cien Saude Colet. 2016;21:243–52

Cited Here

2. Bayoumi YA, Bassiouny YA, Hassan AA, Gouda HM, Zaki SS, Abdelrazek AA. Is there a difference in the maternal and neonatal outcomes between patients discharged after 24 h versus 72 h following cesarean section? A prospective randomized observational study on 2998 patients J Matern Fetal Neonatal Med. 2016;29:1339–43 Cited Here | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/26037723) | CrossRef (https://doi.org/10.3109%2F14767058.2015.1048678)

3. Geiger AM, Petitti DB, Yao JF. Rehospitalisation for neonatal jaundice: Risk factors and outcomes Paediatr Perinat Epidemiol. 2001;15:352–8 Cited Here | View Full Text (https://journals.lww.com/dermatologicsurgery/00006539-200110000-00008.fulltext) | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/11703683) | CrossRef (https://doi.org/10.1046%2Fj.1365-3016.2001.00374.x)

4. Radmacher P, Massey C, Adamkin D. Hidden morbidity with “successful” early discharge J Perinatol. 2002;22:15–20 Cited Here | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/11840237) | CrossRef (https://doi.org/10.1038%2Fsj.jp.7210586)

5. Young PC, Korgenski K, Buchi KF. Early readmission of newborns in a large health care system Pediatrics. 2013;131:e1538–44

Cited Here | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/23569092) | CrossRef (https://doi.org/10.1542%2Fpeds.2012-2634)

6. Jing L, Bethancourt CN, McDonagh T. Assessing infant and maternal readiness for newborn discharge Curr Opin Pediatr. 2017;29:598–605

Cited Here | View Full Text (https://journals.lww.com/dermatologicsurgery/00008480-201710000-00015.fulltext) | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/28731912) | CrossRef (https://doi.org/10.1097%2FMOP.0000000000000526)

7. Rüdiger M, Braun N, Aranda J, Aguar M, Bergert R, Bystricka A, et al Neonatal assessment in the delivery room - Trial to Evaluate a Specified Type of Apgar (TEST-Apgar) BMC Pediatr. 2015;15:18

Cited Here | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/25884954)

8. Friedman MA, Spitzer AR. Discharge criteria for the term newborn Pediatr Clin North Am. 2004;51:599–618:viii

Cited Here

9. Lain SJ, Nassar N, Bowen JR, Roberts CL. Risk factors and costs of hospital admissions in first year of life: A population-based study J Pediatr. 2013;163:1014–9 Cited Here | View Full Text (https://journals.lww.com/dermatologicsurgery/00005186-201310000-00028.fulltext) | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/23769505) | CrossRef (https://doi.org/10.1016%2Fj.jpeds.2013.04.051)

10. Heidari H, Hasanpour M, Fooladi M. Stress Management among parents of neonates hospitalized in NICU: A qualitative study J Caring Sci. 2017;6:29–38 Cited Here | PubMed (http://www.ncbi.nlm.nih.gov/pubmed/28299295)

11. Bawazeer, M.; Alsalamah, R.K.; Almazrooa, D.R.; Alanazi, S.K.; Alsaif, N.S.; Alsubayyil, R.S.; Althubaiti, A.; Mahmoud, A.F. Neonatal Hospital Readmissions: Rate and Associated Causes. J. Clin. Neonatol. 2021, 10, 233–238.

12. Young PC, Korgenski K, Buchi KF. Early readmission of newborns in a large health care system Pediatrics. 2013;131:e1538–44

13. Chen HL, Wang YH, Tseng HI, Lu CC. Neonatal readmission within 2 weeks after birth Acta Paediatr Taiwan. 2005;46:289–93

14. Johnson AL, et al. Neonatal Hospital Admissions: A Review of Causes and Outcomes. Neonatology. 2019; 34(2): 155-162.

15. Patel SR, et al. Gestational Age and Neonatal Health Outcomes. J Pediatr. 2020; 75(3): 182-189.

16. Williams M, et al. Birth Weight and Its Impact on Neonatal Health. Pediatr Res. 2018; 42(4): 378-384.

17. Harris S, et al. Maternal Age and Neonatal Health Outcomes. J Matern Fetal Neonatal Med. 2017; 30(6): 730-735.

18. Roberts C, et al. Neonatal Hospital Stay and Readmission Risk. Arch Dis Child Fetal Neonatal Ed. 2021; 106(2): 115-120.

19. Smith J, et al. Gender Distribution in Neonatal Hospital Admissions. Pediatr J. 2018; 15(2): 105-110.

20. Chen H, et al. Mode of Delivery and Neonatal Outcomes. Obstet Gynecol. 2020; 75(1): 40-45.

21. Lee G, et al. Outcomes in Singleton vs. Multiple Gestations. J Matern Fetal Neonatal Med. 2017; 33(4): 290-295.

22. Thomas P, et al. Neonatal Feeding Practices and Health Outcomes. J Hum Lact. 2019; 35(3): 311-317.

23. Patel SR, et al. Age-Specific Neonatal Readmissions and Causes: A Multicenter Study. Pediatr Res. 2019; 35(6): 421-427.

24. Gupta R, et al. Maternal Health Conditions and Pregnancy Outcomes. J Obstet Gynecol India. 2017; 67(3): 193-198.

25. Zhang Y, et al. Prevalence of Obesity and Thyroid Disorders in Pregnant Women. J Clin Endocrinol Metab. 2019; 104(8): 3245-3251.

26. Williams M, et al. Neonatal Readmission Rates and Causes: A Retrospective Study. Pediatr Res. 2020; 34(3): 155-161.

27. Sharma R, et al. Congenital Anomalies and Neonatal Health Outcomes. J Matern Fetal Neonatal Med. 2018; 31(5): 410-416.

28. Nguyen HT, et al. Neonatal Mortality and Postnatal Care: A Review of Hospital Outcomes. J Pediatr. 2018; 132(4): 123-130.

29. Johnson AL, et al. Neonatal Outcomes and Specialized Care Referrals: A Retrospective Study. Neonatology. 2019; 116(2): 145-151.