Evaluation and impact on incidence of admission to the neonatal care unit in cases of jaundice after early discharge form the nursery

UNLABELLED: We have evaluated the entity of admissions to the Neonatal Care Unit (NCU) for jaundice in the period 1996-2000 of babies early discharged from the Nursery (36-48 hours for spontaneous deliveries and 72-96 hours for cesarean section). We have found an increasing trend of admissions for jaundice (R2 = 0.76), proportional to the increasing practice of early discharge and the early discharge also for infants 34-37 weeks' gestation. The admissions for jaundice from home have increased about 8 times from 1996 to 2000, respectively from 8 to 65 cases. The mean value of maximum total bilirubinemia at admission was 20.5 +/- 2.7 mg/dl. None of the infants underwent exchange transfusion. The most part of the jaundices (69/123) were idiopathic in term infants, followed by those in preterm babies (24/123) and by those in ABO incompatibility without hemolytic disease (15/123). Mean age at admission of the total population was 6.5 +/- 3.0 days, and 9 newborns had signs of dehydration at admission, with weight loss between 11 and 13.8% from birth. Also the admissions for jaundice of extracomunitary babies have resulted increased and they had a longer hospitalization than the rest of the population (p = 0.02). CONCLUSIONS: Early discharge from the Nursery has determined an increase of admissions to NCU for jaundice. New criteria have to be considered to select more carefully the infants that can benefit of this practice.