Post-discharge referrals of newborns in inland Rio Grande do Norte

Abstract

Introduction: In Brazil, there are no well-established pathways for the identification and follow-up of children at high risk for neurodevelopmental disorders, which hinders early diagnosis and timely intervention. Objective: To outline the profile of newborns (NBs) referred at hospital discharge in a public hospital located in the interior of Rio Grande do Norte, Brazil. MethodS: A retrospective cross-sectional study was conducted using data extracted from medical records through a structured questionnaire. All NBs admitted to the study hospital between October 2023 and March 2024 were included, except those transferred to another unit or who died during hospitalization. Data were analyzed using SPSS version 22.0. Descriptive statistics (frequencies and percentages), normality tests, the Mann–Whitney U test, and the Chi-square test were applied. Results: A total of 253 NBs were included, of whom 79 (31.2%) were referred at hospital discharge. Among these, 60 (75.9%) were born at term and 63 (79.7%) were classified as appropriate for gestational age. Regarding risk factors for neurodevelopmental disorders, eight (10.1%) required positive pressure ventilation in the first minutes of life and had Apgar scores of 1 and 4 at the 1st and 5th minutes, respectively. Among the variables analyzed, only neonatal jaundice was significantly associated with referrals (p = 0.036). Conclusion: Children with risk factors for neurodevelopmental disorders were identified but not referred to specialists or rehabilitation services, highlighting the lack of standardized care pathways.