Efficacy of early newborn discharge in a middle-class population.

The safety of early newborn discharge was assessed by determining the incidence, time of onset, and nature or problems requiring hospitalization that appeared in the first two weeks of life among 1,735 consecutively born term infants in a private metropolitan hospital. Infants with and without abnormalities during the initial six-hour transitional period were compared. Of 1,583 initially well infants, 11 (0.7%) had problems other than jaundice develop that required hospitalization in the first three days of life. In contrast, 42 (28%) of the 152 infants with abnormal transitional periods required prolonged hospital care; this was statistically significant. The nature of the problems occurring before and after 72 hours was similar, jaundice being the most common and occurring with equal frequency in both periods. Most illness requiring hospitalization in the first three days of life could have been safely detected during an outpatient visit; these findings, in addition to a cost-benefit estimate, suggest that early discharge of initially well infants with careful follow-up may be an effective alternative to a traditional three-day stay.