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December 17, 1997

Early Discharge of Newborns

JAMA. 1997;278(23):2066. doi:10.1001/jama.1997.03550230042030

To the Reply  —Although we commend Dr Liu and colleagues1 for attempting to address the complex and controversial issue of safety of early newborn discharge, we find their conclusions misleading and premature given the tenuousness of the data presented.First, although the authors claim that early discharge was associated with an increased risk of sepsis, their data do not clearly support this conclusion. Table 4 in their article lists an unadjusted OR for sepsis in early discharge infants of 1.53 (95% CI, 1.00-2.33), and the difference compared with infants discharged later did not reach statistical significance. The same concerns hold for their conclusions regarding dehydration risk (unadjusted OR, 1.28; 95% CI, 0.87-1.88).Second, the study design did not allow for a uniform definition of pathologic hyperbilirubinemia. It is likely that some infants admitted with this diagnosis had mild or physiologic jaundice that was managed in an inappropriately aggressive manner. Our teaching faculty