Taking Newborns Home Too Early May Be Risky
Aug. 4, 2000 -- Going home from the hospital with your newborn
is an exciting, emotional time. But a new survey reinforces the fear that
checking out too soon can put some little ones at higher risk of dying within
the first year of life from medical problems that are not always apparent in
the first hours after birth.
In recent years, managed-care companies have put pressure on
hospitals and doctors to send women home with their babies as soon as possible.
Congress recently passed a law requiring insurers to allow women and their
babies to stay in the hospital for 48 hours after a vaginal birth and 96 hours
after a cesarean delivery. Nonetheless, many mothers and newborns continue to
go home sooner.
"There is always pressure to get mothers out," says
Moshe Ipp, MD, a pediatrician at the Hospital for Sick Children in Toronto.
"But if the mother says she wants to go, the hospital will let them go
unless [physicians] feel there is a risk factor." In Canada, new moms may
stay as long as 60 hours and the insurance company must pay for it.
How early is too early to go home with your baby? In the survey
of women who gave birth in Washington State in 1989 and 1990, babies sent home
within 30 hours were almost four times more likely to die of heart-related
illnesses, and nearly five times more likely to die of infection within one
year of birth, than infants discharged later. Infants discharged early were
also 44% more likely to die of sudden infant death syndrome (SIDS) than those
The survey's main author, Jesse D. Malkin, PhD, tells WebMD the
study is the first to find an association between early discharge and deaths of
any cause in newborns."We found a significantly increased risk of death
among newborns with very short hospital stays," says Malkin, a researcher
at Covance Health Economics and Outcomes Services in Gaithersburg, Md.
Heart-related problems can be tricky to diagnose and may not be
apparent for several days after the baby is born. The same is true for some
potentially dangerous infections.
In the survey, published in the August issue of the journal
Obstetrics & Gynecology, babies of poorer mothers and mothers who
had given birth previously were more likely to be sent home early. Early
discharge was highest among Hispanic mothers and infants. Very late discharge
(more than 78 hours after birth) was highest among babies born by cesarean
Of 155 deaths occurring in the first year of life, 66.5% were
attributed to SIDS. In the past few years, the American Academy of Pediatrics
has tried to educate mothers that putting babies to sleep on their backs can
virtually eliminate the risk of SIDS.