Objective: To determine the risk factors associated with readmission of jaundiced newborn infants within the first 28 days after birth.
Methods: Retrospective review of all newborns ≥35 weeks with jaundice born between January 2010 and January 2019 at three university hospitals. Potential risk factors and readmission for hyperbilirubinemia were collected. Descriptive analysis, non- parametric testing, chi-quare and multivariate linear regression were computed using statistical Package of the Social Sciences (SPSS) version 24.
Results: Among the 215 subjects with neonatal jaundice 51 (23.7%) were readmitted for hyperbilirubinemia. Screening practice for hyperbilirubinemia prior to discharge was not unified. For late preterm and early term the rate of readmission was 30.6% and for term infants 20.9%. Lower gestational age (p=0.04), exclusive breastfeeding (p=0.045), feeding ≤8 times per 24 hours (p=0.016) and hospital stay ≤53 hours (p<0.0001) were associated with more readmission. After adjustment for confounders, risk of readmission was lower for infants receiving mixed or formula milk feeding compared to exclusive breast feeding (aOR=0.53 [95% CI= 0.56-0.98], p=0.046); feeding > 8 times per day with each additional feed odds decreased by 0.46 [95% CI: 0.23–0.91], p=0.016) and stayed > 2 days after birth (aOR 0.94 [95 CI=0.93-0.97] (p=<0.001)).
Infants born via vaginal delivery and are on exclusive breastfeeding have a decreased chance of readmission for hyperbilirubinemia. Keeping newborns beyond the first 24 hours and ensuring adequate daily feeding decreases this chance. Screening for hyperbilirubinemia and parental education with close follow up are needed especially when infants are discharged within 2 days of birth.