541: Short interpregnancy intervals and health services utilization: is neonatal hospital readmission associated with short intervals?

Abstract

services utilization: is neonatal hospital readmission associated with short intervals? Allison Bryant, Erin Madden Massachusetts General Hospital, Vincent Obstetrics & Gynecology, Maternal Fetal Medicine, Boston, MA, Veteran’s Research Institute, NCIRE, San Francisco, CA OBJECTIVE: Short interpregnancy intervals (IPI) are associated with preterm birth. We explored whether birth-to-conception intervals less than 6 months are associated with neonatal hospital readmission above and beyond the effects prematurity. STUDY DESIGN: Data from vital statistics records for all births in California between 1999 and 2004 were linked with hospital discharge data. For women with a first birth in 1999-2000 and a second before the end of 2004, multivariable logistic regression was used to determine risk factors for hospital readmission for neonates any time in the first year of life. Negative binomial regression was used to determine risk factors for total length of neonatal hospital stay (LOS), excluding the birth admission. RESULTS: Of 190,889 infants born to mothers meeting inclusion criteria, 20,015 (10%) were readmitted during the first year of life. The leading diagnoses for these admissions included respiratory (20%), infectious (12%), gastrointestinal/dehydration/nutrition (10%), jaundice (6%) and cardiac etiologies(6%). Factors associated with readmission are presented in the Table, and include IPI 18 months (8 vs. 6d, p 0.001). IPI was not statistically significantly associated with neonatal LOS once gestational age at birth was accounted for. CONCLUSION: Short IPI is associated with increased use of health care resources: independent of gestational age, IPI 6 months is associated with a greater risk of hospital readmission for neonates. The overall length of stay for these admissions does not vary by IPI independent of IPI’s association with prematurity, a risk factor for increased hospital utilization in the first year of life.