Aims: To investigate infant deaths in Cumbria, 1950-93, in relation to individual and community level socioeconomic status. Methods: Retrospective birth cohort study of all 283 668 live births and 4889 infant deaths i...Aims: To investigate infant deaths in Cumbria, 1950-93, in relation to individual and community level socioeconomic status. Methods: Retrospective birth cohort study of all 283 668 live births and 4889 infant deaths in Cumbria, 1950-93. Community deprivation (Townsend score) and individual social class were used to estimate socioeconomic status. Logistic regression was used to investigate risk of infant death (early neonatal, neonatal, and postneonatal) in relation to social class and Townsend deprivation score, adjusting for year of birth, birth order, multiple births, and stratified by time period, 1950-65, 1966-75, 1976-85, 1986-93. Results: The risk of infant death in all categories was higher in the lower social classes and more deprived communities, although inequality in risk of neonatal death declined after 1975 to such an extent that there was no significant difference in neonatal death rates by socioeconomic status in the most recent time period. By contrast, there was no narrowing in socioeconomic inequality in postneonatal death risk over the study period. Community deprivation was associated with a significant increased risk of postneonatal death after adjusting for individual level socioeconomic status. Conclusions: Postneonatal deaths remain higher in the most deprived communities and in the more disadvantaged social classes. The social, lifestyle, and environmental determinates of adverse health outcomes for children need to be fully understood, and interventions should be designed and targeted at the more socially deprived sectors of our community.展开更多
Aims: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. Methods: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region o...Aims: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. Methods: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region of the UK were studied. Results: A total of 4743 of 11 338 (42% ) babies were discharged on or before the first postnatal day. Rates of early discharge varied significantly between hospitals. Infants < 2500 g at birth (adjusted odds ratio (AOR) 0.44, 95% CI 0.29 to 0.66), infants 35-37 weeks gestation at birth (AOR 0.65, 95% CI 0.49 to 0.86), and firstborn infants (AOR 0.09, 95% CI 0.08 to 0.10) were less likely to be discharged early. Women from more deprived areas were more likely to be discharged early (AOR1.37,95% CI 1.12 to 1.67). A total of 907 of 32 015 babies liveborn in the region were readmitted to hospital during 1998. Readmission rates varied significantly by hospital of birth but not by timing of discharge. Babies < 2500 g at birth (AOR 1.95, 95% CI 1.16 to 3.28) and babies born at 35-37 weeks gestation (AOR 1.72, 95% CI 1.15 to 2.57) were more likely to be readmitted. Breast fed babies were less likely to be readmitted (AOR 0.69, 95% CI 0.53 to 0.90). Infants initially discharged early were not more likely to be readmitted. Conclusions: Early discharge occurred variably in the Northern Region in 1998. It is not associated with readmission to hospital. Breast feeding is associated with lower rates of readmission to hospital.展开更多
Aims: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. Methods: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region o...Aims: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. Methods: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region of the UK were studied. Results: A total of 4743 of 11 338 (42%) babies were discharged on or before the first postnatal day. Rates of early discharge varied significantly between hospitals. Infants < 2500 g at birth (adjusted odds ratio (AOR) 0.44, 95%CI 0.29 to 0.66), infants 35-37 weeks gestation at birth (AOR 0.65, 95%CI 0.49 to 0.86), and firstborn infants (AOR 0.09, 95%CI 0.08 to 0.10) were less likely to be discharged early. Women from more deprived areas were more likely to be discharged early (AOR1.37, 95%CI 1.12 to 1.67). A total of 907 of 32 015 babies liveborn in the region were readmitted to hospital during 1998. Readmission rates varied significantly by hospital of birth but not by timing of discharge. Babies < 2500 g at birth (AOR 1.95, 95%CI 1.16 to 3.28) and babies born at 35-37 weeks gestation (AOR 1.72, 95%CI 1.15 to 2.57) were more likely to be readmitted. Breast fed babies were less likely to be readmitted (AOR 0.69, 95%CI 0.53 to 0.90). Infants initially discharged early were not more likely to be readmitted. Conclusions: Early discharge occurred variably in the Northern Region in 1998. It is not associated with readmission to hospital. Breast feeding is associated with lower rates of readmission to hospital.展开更多
文摘Aims: To investigate infant deaths in Cumbria, 1950-93, in relation to individual and community level socioeconomic status. Methods: Retrospective birth cohort study of all 283 668 live births and 4889 infant deaths in Cumbria, 1950-93. Community deprivation (Townsend score) and individual social class were used to estimate socioeconomic status. Logistic regression was used to investigate risk of infant death (early neonatal, neonatal, and postneonatal) in relation to social class and Townsend deprivation score, adjusting for year of birth, birth order, multiple births, and stratified by time period, 1950-65, 1966-75, 1976-85, 1986-93. Results: The risk of infant death in all categories was higher in the lower social classes and more deprived communities, although inequality in risk of neonatal death declined after 1975 to such an extent that there was no significant difference in neonatal death rates by socioeconomic status in the most recent time period. By contrast, there was no narrowing in socioeconomic inequality in postneonatal death risk over the study period. Community deprivation was associated with a significant increased risk of postneonatal death after adjusting for individual level socioeconomic status. Conclusions: Postneonatal deaths remain higher in the most deprived communities and in the more disadvantaged social classes. The social, lifestyle, and environmental determinates of adverse health outcomes for children need to be fully understood, and interventions should be designed and targeted at the more socially deprived sectors of our community.
文摘Aims: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. Methods: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region of the UK were studied. Results: A total of 4743 of 11 338 (42% ) babies were discharged on or before the first postnatal day. Rates of early discharge varied significantly between hospitals. Infants < 2500 g at birth (adjusted odds ratio (AOR) 0.44, 95% CI 0.29 to 0.66), infants 35-37 weeks gestation at birth (AOR 0.65, 95% CI 0.49 to 0.86), and firstborn infants (AOR 0.09, 95% CI 0.08 to 0.10) were less likely to be discharged early. Women from more deprived areas were more likely to be discharged early (AOR1.37,95% CI 1.12 to 1.67). A total of 907 of 32 015 babies liveborn in the region were readmitted to hospital during 1998. Readmission rates varied significantly by hospital of birth but not by timing of discharge. Babies < 2500 g at birth (AOR 1.95, 95% CI 1.16 to 3.28) and babies born at 35-37 weeks gestation (AOR 1.72, 95% CI 1.15 to 2.57) were more likely to be readmitted. Breast fed babies were less likely to be readmitted (AOR 0.69, 95% CI 0.53 to 0.90). Infants initially discharged early were not more likely to be readmitted. Conclusions: Early discharge occurred variably in the Northern Region in 1998. It is not associated with readmission to hospital. Breast feeding is associated with lower rates of readmission to hospital.
文摘Aims: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. Methods: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region of the UK were studied. Results: A total of 4743 of 11 338 (42%) babies were discharged on or before the first postnatal day. Rates of early discharge varied significantly between hospitals. Infants < 2500 g at birth (adjusted odds ratio (AOR) 0.44, 95%CI 0.29 to 0.66), infants 35-37 weeks gestation at birth (AOR 0.65, 95%CI 0.49 to 0.86), and firstborn infants (AOR 0.09, 95%CI 0.08 to 0.10) were less likely to be discharged early. Women from more deprived areas were more likely to be discharged early (AOR1.37, 95%CI 1.12 to 1.67). A total of 907 of 32 015 babies liveborn in the region were readmitted to hospital during 1998. Readmission rates varied significantly by hospital of birth but not by timing of discharge. Babies < 2500 g at birth (AOR 1.95, 95%CI 1.16 to 3.28) and babies born at 35-37 weeks gestation (AOR 1.72, 95%CI 1.15 to 2.57) were more likely to be readmitted. Breast fed babies were less likely to be readmitted (AOR 0.69, 95%CI 0.53 to 0.90). Infants initially discharged early were not more likely to be readmitted. Conclusions: Early discharge occurred variably in the Northern Region in 1998. It is not associated with readmission to hospital. Breast feeding is associated with lower rates of readmission to hospital.
