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Amy Lansky, MPH, PhD1, Wanda D. Barfield, MD, MPH2, Kristen S. Marchi, MPH3, Susan A. Egerter, PhD4, and Paula A. Braveman, MD, MPH4. (1) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K22, Atlanta, GA 30341, 7704886284, all0@cdc.gov, (2) Centers for Disease Control & Prevention, 4770 Buford Highway, K-23, Atlanta, GA 30341-3724, (3) Department of Family and Community Medicine, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143-0900, (4) Family and Community Medicine, University of California, San Francisco, 500 Parnassus, MU-3E, Box 0900, San Francisco, CA 94947
Background: Guidelines recommend follow-up visits for newborns within 48 hours of early discharge. Little is known about the postnatal services that newborns are receiving. Objectives: To describe the extent to which newborns discharged early receive recommended follow-up, the characteristics of newborns discharged early who do not receive recommended follow-up, and how breastfeeding and receipt of well-baby checkups vary by postnatal care received. Methods: We analyzed data from 19 states in PRAMS, a population-based survey of postpartum women, in 2000. We calculated prevalence for early discharge (2 days or less), lack of follow-up (within 1 week) after early discharge, breastfeeding, and well-baby checkups; we calculated unadjusted odds ratios (OR) for each outcome by maternal characteristics. Results: Most (83.6%-93.4%) healthy newborns were discharged early, and most of those (51.5%-86.8%) received follow-up within 1 week of discharge. Lack of follow-up was associated with lower income (7 states, OR range: 1.5-2.3), less education (5 states, OR range:1.7-2.2), and Medicaid coverage (5 states, OR range: 1.6-2.0). Although breastfeeding at 2 months varied by state, within states the prevalence was similar across postnatal care group (not discharged early [25.6%-70.8%], discharged early with follow-up [31.2%-75.0%], discharged early without follow-up [30.7%-73.0%]). Similarly, most infants, regardless of postnatal care group, had received a well-baby visit by the time of the survey (93.6%–100%). Conclusions: Early discharge and follow-up was highly prevalent in all 19 PRAMS states. Infants of women with lower income or education, or on Medicaid may need targeted support to assure appropriate newborn follow-up care.
Learning Objectives: By the end of this session, the participants will be able to
Keywords: Insurance-Related Barriers, Infant Health
Related Web page: www.cdc.gov\reproductivehealth\srv_prams.htm
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.