The Frequency of Infant-Feeding Presentations at English Emergency Departments During the SARS-CoV-2 Pandemic: A Nation-Wide Electronic Health Records Study

Wyatt, Steven; Aldridge, Patrick; Ross, Samantha; Narayanan, Sankara; Zuccolo, Luisa

doi:10.7759/cureus.27645

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…While some studies suggest that the frequency of overall post-discharge newborn rehospitalization did not change during the pandemic [28,29], there have been reports of increased rehospitalization risk in some subgroups such as those born to nulliparous mothers [30] and those readmitted for hyperbilirubinemia [31]. One nation-wide study from England found that while acute care presentations decreased by 16.7% overall during vs. before the pandemic, attendance for feeding problems and neonatal jaundice increased by 7.5% and 12.8% respectively [32]. Such presentations may -in particular -rely on in-person primary care assessment to help prevent poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Cohen,

Stukel,

Wang

et al. 2024

BMC Prim. Care

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Background Early post-discharge assessments for newborns are recommended. Virtual care has become more prevalent during the pandemic, providing an opportunity to better understand its impact on the quality of post-discharge newborn care. The objective of this study was to understand whether primary care visit modality (in-person vs. virtual) is associated with early newborn hospital readmissions and emergency department (ED) visits. Methods We conducted a population-based, case-control study using linked health administrative databases between September 1, 2020 and March 31, 2022 in Ontario, Canada. We compared the modality of primary care visits among cases (hospital readmission within 14 days of life) and controls (newborns without a readmission), matched on infant sex, gestational age, and maternal parity. We included an alternative definition of cases as a composite of either a newborn hospital readmission or emergency department (ED) visit or in-hospital death within the first 14 days of life. Conditional logistic regression models were used to model odds ratios (ORs), comparing those exposed to a virtual visit versus in-person visit, adjusting for infant birth weight, birth hospitalization length of stay, neighbourhood level material deprivation, rurality and presence of active maternal comorbidities. Results Among 73,324 eligible newborns, 2,220 experienced a hospital readmission within 14 days of life and were matched to 8,880 controls. Jaundice was the primary reason for readmission (75% of readmissions). Compared to newborns who were seen in-person post-discharge, newborns who were seen virtually had higher odds of hospital readmission (adjusted odds ratio [aOR] 1.41 (95% CI 1.09, 1.83); the magnitude of effect was not different using the composite outcome (aOR 1.35, 95% CI 1.05, 1.75). Conclusions Newborns who receive a virtual post-discharge visit are more likely than those who receive an in-person visit to require hospital readmission.

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Section: Discussionmentioning

confidence: 99%

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Cohen,

Stukel,

Wang

et al. 2024

BMC Prim. Care

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“…While data on breastfeeding difficulties were not collected in the NMS, loss of full breastfeeding at 6 weeks may reflect unresolved feeding difficulties and maternal confidence [28,29]. Routine data for England showed a 7.5% increase in emergency department attendance for feeding problems in infants during the pandemic, including a 12.8% increase for neonatal jaundice [30]. In addition, we observed an increase in the prevalence of postnatal anxiety and depression in the NMS [6] and similar increases have been found in other studies [31,32].…”

Section: Plos Onementioning

confidence: 99%

Breastfeeding rates in England during the Covid-19 pandemic and the previous decade: Analysis of national surveys and routine data

Quigley,

Harrison,

Levene

et al. 2023

PLoS ONE

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Background Few studies have compared breastfeeding rates before and during the pandemic using comparable data across time. We used data from two national maternity surveys (NMS) to compare breastfeeding rates in England before and during the pandemic. Methods Analysis was conducted using the NMS from 2018 (pre-pandemic; n = 4,509) and 2020 (during the pandemic; n = 4,611). The prevalence of breastfeeding initiation, and ‘any’ breastfeeding and exclusive breastfeeding (EBF) at 6 weeks and 6 months were compared between these surveys. Data were interpreted in the context of underlying trends in these prevalences from previous NMS (from 2010 and 2014), and annual routine data for England (from 2009–10 to 2020–21). Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for the effect of birth during the pandemic (2020 versus 2018) on breastfeeding, with adjustment for sociodemographic and birth-related factors. Results Breastfeeding initiation and any breastfeeding at 6 weeks remained relatively constant in the NMS and the routine data. Birth during the pandemic was associated with a 3 percentage point decrease in EBF at 6 weeks in the NMS (aRR 0.92, 95%CI: 0.87, 0.98 for pandemic versus pre-pandemic), but a smaller decrease in the routine data. Birth during the pandemic was associated with a 3 percentage point increase in any breastfeeding at 6 months in the NMS (aRR 1.05, 95%CI: 1.00, 1.10). Breastfeeding varied across different groups of women in the NMS (i.e. marked inequalities), but the small changes observed between the pandemic and pre-pandemic NMS were broadly similar across the sociodemographic and birth-related factors examined (i.e. no change in inequalities). Conclusion Breastfeeding initiation and any breastfeeding at 6 weeks in England were unaffected by the pandemic, and the persistent inequalities in breastfeeding did not widen. Services should aim to reduce these inequalities in breastfeeding which have been documented since the 1970s.

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The Frequency of Infant-Feeding Presentations at English Emergency Departments During the SARS-CoV-2 Pandemic: A Nation-Wide Electronic Health Records Study

Abstract: Objectives: To examine the frequency and distribution of infant feeding-related presentations at emergency departments (EDs) before and during the SARS-CoV-2 pandemic.

Cited by 2 publications

References 28 publications

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Breastfeeding rates in England during the Covid-19 pandemic and the previous decade: Analysis of national surveys and routine data

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