Newborn infant in the emergency department - case series of 2011 in a hospital center

Abstract

Introduction: The birth of a child is a challenge for parents. Thus, during the neonatal period many questions arise to parents, leading to frequent visits to the Emergency Department (ED), often unjustified from a clinical point of view.

Objectives: Characterization of newborn visits to the paediatric ED for a 12 months’ period, and evaluation of the need for emergency paediatric care..

Material and methods: Retrospective study of all neonates’ visits to the ED in our hospital from January to December 2011, analysing clinical and demographic data.

Results: During the study period, a total of 394 neonates were admitted in the ED (20% visited more than once), representing 1,3% of all paediatric visits; 20% were referred by health professionals. The main causes of ED utilisation were alimentary tract complaints (31%), dermatological issues (18%), jaundice(17%) and respiratory symptoms (15%). Diagnostic tests were required in 44%, mostly transcutaneous bilirubin measurement and urine analysis. Only 18% of the patients received treatment. The most frequent diagnoses were benign neonatal pathology and healthy care child issues in 57% of cases (n=283). The majority of neonates (75,6%) was discharged. 56,8% of mothers were primiparous and the median maternal age was 30 years. Half of the mothers with known literacy skills, studied during more than nine years.

Conclusions: Most neonatal utilisation of emergency paediatric services is due to non-urgent conditions that could be managed in primary care. We underline the importance of proper support and education of mothers during pregnancy and neonatal period. Nevertheless due to the lack of specificity of the neonatal symptoms, paediatricians must be alert to rule out severe disease.