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. 2024 Jan;113(1):48-55.
doi: 10.1111/apa.16934. Epub 2023 Aug 11.

Nordic survey showed wide variation in discharge practices for very preterm infants

Sofia Arwehed  1 , Anna Axelin  1   2 , Lars J Björklund  3 , Ylva Thernström Blomqvist  1 , Christian Heiring  4 , Baldvin Jonsson  5 , Claus Klingenberg  6   7 , Marjo Metsäranta  8 , Johan Ågren  1 , Liisa Lehtonen  9
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Nordic survey showed wide variation in discharge practices for very preterm infants

Sofia Arwehed et al. Acta Paediatr. 2024 Jan.

Abstract

Aim: We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units.

Methods: Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments.

Results: We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay.

Conclusion: Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.

Keywords: early discharge; length of stay; neonatal home care; preterm infant; telemedicine.

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