Maternal and neonatal factors associated with hospital readmission of newborns of adolescent mothers

Amthauer, Camila; Cunha, Maria Luzia Chollopetz da

doi:10.1590/1983-1447.2023.20220063.en

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Original Article • Rev. Gaúcha Enferm. 44 • 2023 • https://doi.org/10.1590/1983-1447.2023.20220063.en copy

Maternal and neonatal factors associated with hospital readmission of newborns of adolescent mothers

Factores maternos y neonatales asociados al reingreso hospitalario de recién nacidos de madres adolescentes

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the maternal and neonatal factors in newborns of adolescent mothers associated with hospital readmission in the neonatal period.

Method:

Quantitative cross-sectional, retrospective and analytical study, with 489 newborns of adolescent mothers, born in 2019 and 2020 in a high-complexity public hospital in southern Brazil. Data were collected through a query and analyzed in the SPSS software using the chi-square or Fisher’s exact tests. To control for confounding factors, the multivariate Poisson regression model was used.

Results:

The prevalence of hospital readmissions for newborns of adolescent mothers was 9.2%, mainly due to respiratory conditions, being the most prevalent the diagnosis of acute bronchiolitis, at 22.3%.

Conclusion:

Neonatal hospital readmission was associated with prematurity, 1^st minute Apgar <7 and maternal origin.

Keywords:
Infant; newborn; Premature birth. Pregnancy in adolescence; Neonatal nursing; Intensive care units; neonatal

Variables*	Total sample (n=489)	Neonatal readmission Yes (n=45)No (n=444)		p-value
Gender				0.341^†
Male	244 (49.9)	26 (10.7)	218 (89.3)
Female	245 (50.1)	19 (7.8)	226 (92.2)
Birth weight				0.735^‡
<2.500 g	28 (5.7)	3 (10.7)	25 (89.3)
≥ 2.500 g	461 (94.3)	42 (9.1)	419 (90.9)
1^st minute Apgar^§				0.041^‡
< 7	15 (3.1)	4 (26.7)	11 (73.3)
≥ 7	470 (96.9)	41 (8.7)	429 (91.3)
5^th minute Apgar^§				1.000^‡
< 7	2 (0.4)	0	2 (100.0)
≥ 7	483 (99.6)	45 (9.3)	438 (90.7)
Prematurity				0.024^‡
Yes	33 (6.7)	7 (21.2)	26 (78.8)
No	456 (93.3)	38 (8.3)	418 (91.7)

Causes for hospital readmissions in the neonatal period*	Total sample (n=45)	%
Acute bronchiolitis	10	22.3
Acute nasopharyngitis (common cold)	4	8.9
Unspecified bronchitis	4	8.9
Unspecified acute bronchitis	4	8.9
Unspecified neonatal jaundice	3	6.8
Acute bronchiolitis due to respiratory syncytial virus	2	4.5
Healthy person accompanying sick person	2	4.5
Unspecified acute upper respiratory infection	1	2.2
Acute bronchiolitis due to other specified microorganisms	1	2.2
Unspecified newborn respiratory distress	1	2.2
Unspecified bronchopneumonia	1	2.2
Unspecified viral meningitis	1	2.2
Unspecified bacterial pneumonia	1	2.2
Unspecified bacterial infection	1	2.2
Unspecified septicemia	1	2.2
Other neonatal hypoglycemia	1	2.2
Unspecified urinary tract infection	1	2.2
Hyperosmolality and hypernatremia	1	2.2
Mucopurulent conjunctivitis	1	2.2
Carcinoma in situ of eye	1	2.2
Injury of brachial plexus	1	2.2
Poisoning by unspecified drugs primarily affecting the autonomic nervous system	1	2.2
Person encountering health services in unspecified circumstances	1	2.2

Variables*	Total sample (n=488)	Neonatal readmission Yes (n=45)No (n=443)		p-value
Maternal age				0.611^†
13 to 16 years old	110 (22.5)	12 (10.9)	98 (89.1)
17 to 19 years old	378 (77.5)	33 (8.7)	345 (91.3)
Origin				0.081^†
City where the hospital is located	365 (74.8)	39 (10.7)	326 (89.3)
Other cities	123 (25.2)	6 (4.9)	117 (95.1)
Education level				0.727^†
Adequate for age	102 (20.9)	8 (7.8)	94 (92.2)
Inadequate for age	386 (79.1)	37 (9.6)	349 (90.4)
Marital status				0.097^‡
With partner	30 (6.1)	0	30 (100.0)
Without partner	458 (93.9)	45 (9.8)	413 (90.2)
Occupation				0.499^†
With occupation	286 (58.6)	29 (10.1)	257 (89.9)
Without occupation	202 (41.4)	16 (7.9)	186 (92.1)
Previous pregnancies				0.595^†
Primiparous	392 (80.3)	38 (9.7)	354 (90.3)
Multiparous	96 (19.7)	7 (7.3)	89 (92.7)
Number of prenatal consultations				0.070^†
Adequate for GA	115 (23.5)	16 (13.9)	99 (86.1)
Inappropriate for GA	374 (76.5)	29 (7.8)	345 (92.2)
Type of delivery				0.758^†
Vaginal	376 (77.0)	36 (9.6)	340 (90.4)
Cesarean section	112 (23.0)	9 (8.0)	103 (92.0)
Risk factors				1.000^†
Yes	80 (16.6)	7 (8.6)	74 (91.4)
No	408 (83.4)	38 (9.3)	370 (90.7)
Childbirth complications				0.801^‡
Yes	51 (10.5)	5 (9.8)	46 (90.2)
No	437 (89.5)	40 (9.2)	397 (90.8)

Variables	PR^† (95% CI)^‡	p-value
Neonatal factors
Prematurity
Yes	2.39 (1.19-4.81)	0.015
1^st minute Apgar
< 7	3.81 (1.77-8.23)	0.001
Maternal factors
Origin
City where the hospital is located	2.20 (1.00-4.83)	0.049

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
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[1] Corresponding author:
Camila Amthauer E-mail: camila.amthauer@hotmail.com