Abstract

AIM. Organisation of neonatal medical care in Estonia has changed over the past 15 years: newborns are discharged earlier from maternity hospitals and followed up by family doctors. This study was undertaken with the aim to analyse the reasons for readmissions during the neonatal period. 

METHODS. Retrospective analysis of the hospital charts of the newborns readmitted to Tallinn Children’s Hospital during the neonatal period in 2005–2006.

RESULTS. During the study period 13,583 live newborns were registered in Tallinn,  360 (2.7%) of them were readmitted: 81 (23%) in their first, 109 (30%) in their second, 89 (25%) in their third and 81 (22%) in their fourth week of life. A total of 64 (18%) newborns were referred to hospital by family doctors, 68 (19%) by emergency doctors and 116 (32%) by different specialists. A total of 112 (31%) babies were brought to the emergency room by parents; 104 (29%) children were readmitted due to infections, 64 (18%) due to neonatal jaundice, 57 (16%) due to feeding difficulties, 27 (7%) due to malformations, 14 (4%) due to neurological pathology, 6 (2%) due to injury, and 88 (24%) with different other problems. Altogether 89% of the newborns with  neonatal jaundice and 68% of those with feeding difficulties were hospitalised during their first two weeks of life. Forty-nine babies had their total bilirubin value over 310 μmol/l; hypernatremic dehydration was diagnosed in only one case. Of the mothers of children with feeding diffi culties 70% were primiparous. Bacterial infection was diagnosed in 54% of the children with infectious pathology.

CONCLUSIONS. Reorganisation of neonatal medical care in Estonia will be effective if primiparous mothers are effectively counselled for breastfeeding and child care. Active follow-up by different specialists may reduce the risk of readmission.