Readmission of late preterm infants after discharge from nursery

신생아실에서 퇴원한 후기 조산아들의 재입원에 대한 고찰

  • Kim, Myo-Jing (Department of Pediatrics, Dong-A University College of Medicine)
  • 김묘징 (동아대학교 의과대학 소아과학교실)
  • Received : 2009.02.17
  • Accepted : 2009.07.22
  • Published : 2009.08.15


Purpose : To evaluate the risk factors for hospital readmission during the neonatal period among late preterm infants who were discharged after nursery care. Methods : In this retrospective study, we reviewed medical records of 135 late preterm infants readmitted to the neonatal intensive care unit (NICU) during the neonatal period, after discharge from nursery of IL Sin Christian Hospital from January 2003 to December 2008. We compared the risk factors of the hospital readmission group with the control group. Results : The gestational age and birth weight of 135 study infants were $36^{+1}{\pm}0.5$ weeks and $2,718.4{\pm}296.9gm$, respectively. Identified risk factors of hospital readmission were breastfeeding (71.9% vs. 44.4%), short duration of nursery stay ($3.3{\pm}1.6$ days vs. $4.1{\pm}2.0$ days), firstborn (60.0% vs. 45.3%), and maternal pregnancy complication (31.9% vs. 18.8%). Jaundice accounted for the majority of hospital readmissions (83.7%), and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days, mostly at 5-6 postnatal days (40.7%). Identified risk factors of hospital readmission due to jaundice were spontaneous normal vaginal delivery (43.4% vs. 1.8%), younger maternal age ($29.8{\pm}3.4$ yrs vs. $32.1{\pm}4.2$ yrs), and lower maternal pregnancy complication (28.3% vs. 50%). Conclusion : Identified risk factors of hospital readmission were breastfeeding, short duration of nursery stay, firstborn, and maternal pregnancy complication. Jaundice accounted for the majority of hospital readmissions, and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days.


Supported by : Dong-A University


  1. Kim KA. Checklist of late-preterm infant.Korean J Perinatol 2008;19:123-30
  2. Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Weiss J, Evans S. Risk factors for neonatal morbidity and mortality among "healthy," late preterm newborns. Semin Perinatol 2006;30:54-60
  3. Tomashek KM, Shapiro-Mendoza CK, Weiss J, Kotelchuck M, Barfield W, Evans S, et al. Early discharge among late preterm and term newborns and risk of neonatal morbidity. Semin Perinatol 2006;30:61-8
  4. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births: final data for 2004. Natl Vital Stat Rep 2006;55:1-101
  5. Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol 2006;30:28-33
  6. Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of near-term infants. Pediatrics 2004;114:372-6
  7. Adams-Chapman I. Neurodevelopmental outcome of the late preterm infant. Clin Perinatol 2006;33:947-64
  8. Engle WA. A recommendation for the definition of "late preterm" (near-term) and the birth weight-gestational age classification system. Semin Perinatol 2006;30:2-7
  9. Dobak WJ, Gardner MO. Late preterm gestation: physiology of labor and implications for delivery. Clin Perinatol 2006; 33:765-76
  10. Heffner LJ. Advanced maternal age--how old is too old? N Engl J Med 2004;351:1927-9
  11. Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics 2006;118:1207-14
  12. Lee YM, Cleary-Goldman J, D'Alton ME. Multiple gestations and late preterm (near-term) deliveries. Semin Perinatol 2006;30:103-12
  13. American Academy of Pediatrics. Guidelines for perinatal care. 6th ed. Washington, DC : American Academy of Pediatrics and American College of Obstetricians and Gynecologist, 2007
  14. Fuchs K, Gyamfi C. The influence of obstetric practices on late prematurity. Clin Perinatol 2008;35:343-60
  15. Centers for Disease Control and Prevention. Genital HPV Infection-CDC Fact Sheet. Retrieved May 9, 2008, from
  16. Jorgensen AM. Late preterm infants: clinical complications and risk: part two of a two-part series. Nurs Womens Health 2008;12:316-30
  17. Santos IS, Matijasevich A, Silveira MF, Sclowitz IK, Barros AJ, Victora CG, et al. Associated factors and consequences of late preterm births: results from the 2004 Pelotas birth cohort. Paediatr Perinat Epidemiol 2008;22:350-9
  18. Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Nannini A, Weiss J, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics 2008;121:e223-32
  19. Darnall RA, Ariagno RL, Kinney HC. The late preterm infant and the control of breathing, sleep, and brainstem development: a review. Clin Perinatol 2006;33:883-914
  20. Jain L, Eaton DC. Alveolar fluid transport: a changing paradigm. Am J Physiol Lung Cell Mol Physiol 2006;290:646-8
  21. Blackburn S. Carbohydrate, fat, and protein metabolism. In : Maternal, fetal and neonatal physiology: A clinical perspective. 3rd ed. St. Louis : WB Saunders Co, 2007:598-625
  22. Watchko JF. Hyperbilirubinemia and bilirubin toxicity in the late preterm infant. Clin Perinatol 2006;33:839-52
  23. Gray RF, Indurkhya A, McCormick MC. Prevalence, stability, and predictors of clinically significant behavior problems in low birth weight children at 3, 5, and 8 years of age. Pediatrics 2004;114:736-43