OBJECTIVES To determine if birth hospitalization length of stay (LOS) and infant rehospitalization changed during the coronavirus disease 2019 (COVID-19) era among healthy, term infants. METHODS Retrospective cohort study using Epic's Cosmos data from 35 health systems of term infants discharged ≤5 days of birth. Short birth hospitalization LOS (vaginal birth <2 midnights; cesarean birth <3 midnights) and, secondarily, infant rehospitalization ≤7 days after birth hospitalization discharge were compared between the COVID-19 (March 1 to August 31, 2020) and prepandemic eras (March 1 to August 31, 2017, 2018, 2019). Mixed-effects models were used to estimate adjusted odds ratios (aORs) comparing the eras. RESULTS Among 202 385 infants (57 110 from the COVID-19 era), short birth hospitalization LOS increased from 28.5% to 43.0% for all births (vaginal: 25.6% to 39.3%, cesarean: 40.1% to 61.0%) during the pandemic and persisted after multivariable adjustment (all: aOR 2.30, 95% confidence interval [CI] 2.25-2.36; vaginal: aOR 2.12, 95% CI 2.06-2.18; cesarean: aOR 3.01, 95% CI 2.87-3.15). Despite shorter LOS, infant rehospitalizations decreased slightly during the pandemic (1.2% to 1.1%); results were similar in adjusted analysis (all: aOR 0.83, 95% CI 0.76-0.92; vaginal: aOR 0.82, 95% CI 0.74-0.91; cesarean: aOR 0.87, 95% CI 0.69-1.10). There was no change in the proportion of rehospitalization diagnoses between eras. CONCLUSIONS Short infant LOS was 51% more common in the COVID-19 era, yet infant rehospitalization within a week did not increase. This natural experiment suggests shorter birth hospitalization LOS among family- and clinician-selected, healthy term infants may be safe with respect to infant rehospitalization, although examination of additional outcomes is needed.

中文翻译：

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COVID-19 期间出生医院的住院时间和再住院。


目的 确定在 2019 年冠状病毒病 (COVID-19) 时代，健康足月婴儿的出生住院时间 (LOS) 和婴儿再住院是否发生变化。方法 使用 Epic 的 Cosmos 数据对 35 个卫生系统的出生后 5 天以内出院的足月儿进行回顾性队列研究。比较了 COVID-19 期间（2020 年 3 月 1 日至 8 月 31 日）和大流行前时期的短产住院 LOS（阴道分娩 <2 午夜；剖腹产 <3 午夜）以及出生后 7 天以内的婴儿再住院出院情况（2020 年 3 月 1 日至 8 月 31 日）。 2017年、2018年、2019年3月1日至8月31日）。混合效应模型用于估计调整后的比值比 (aOR) 比较各个时代。结果 在 202 385 名婴儿（57 110 名来自 COVID-19 时代）中，大流行期间所有分娩的短产住院 LOS 从 28.5% 增加至 43.0%（顺产：25.6% 至 39.3%，剖腹产：40.1% 至 61.0%）多变量调整后持续存在（全部：aOR 2.30，95% CI 2.25-2.36；阴道：aOR 2.12，95% CI 2.06-2.18；剖宫产：aOR 3.01，95% CI 2.87-3.15）。尽管住院时间较短，但婴儿再住院率在大流行期间略有下降（1.2%至1.1%）；调整分析结果相似（全部：aOR 0.83，95% CI 0.76-0.92；阴道：aOR 0.82，95% CI 0.74-0.91；剖宫产：aOR 0.87，95% CI 0.69-1.10）。不同时代之间再住院诊断的比例没有变化。结论 在 COVID-19 时代，矮小的婴儿 LOS 较常见 51%，但婴儿在一周内再住院的情况并未增加。 这项自然实验表明，尽管需要检查其他结果，但家庭和临床医生选择的健康足月婴儿的出生住院时间较短对于婴儿再住院可能是安全的。