ISSN - 0973-0958

Pediatric Oncall Journal View Article

Newborns in the Pediatric Emergency Department: Patterns of Use and Care Pathways According to Maternal Migratory Status
Catarina Franquelim, Catarina de Almeida Matos, Marta Almeida, Rita Marques.
Paediatrics Department, Almada-Seixal Local Health Unit, Almada, Portugal.
Abstract
Introduction: Newborns represent a substantial proportion of pediatric emergency department visits, often for benign conditions. Migrant families may face structural barriers to accessing primary health care, which may lead to different patterns of emergency department use. This study aims to characterize pediatric emergency department use by newborns of migrant mothers and to compare it with that of newborns of non-migrant mothers.
Methods: Single-center, cross-sectional observational study conducted in a pediatric emergency department in a level II hospital in Portugal. Newborns aged ≤28 days were included. Data on demographic and perinatal characteristics, integration into scheduled care, reasons for admission, referral pathways, diagnoses, and clinical outcomes were collected. Comparisons were performed according to maternal migratory status.
Results: Single-center, cross-sectional observational study conducted in a level II pediatric emergency department in Portugal. Newborns aged ≤28 days were included. Data on demographic and perinatal characteristics, access to scheduled care, reasons for admission, referral pathways, diagnoses, and outcomes were collected and compared according to maternal migratory status.
Conclusion: Newborns of migrant mothers more often attended the pediatric emergency department for benign conditions and showed lower integration into scheduled care. These findings suggest that barriers to access and continuity of care shape distinct patterns of neonatal emergency department use, underscoring the need for early postnatal follow-up, improved access to primary care, and accessible guidance pathways such as the telephone triage lines.
Why this article important?
This study highlights structural inequities in access to and continuity of neonatal care, particularly among migrant populations. It demonstrates that emergency department (ED) utilization in this context is primarily driven by gaps in primary care access and follow-up, rather than increased clinical severity. These findings have direct implications for health system organization, supporting the need for early postnatal follow-up, improved and timely access to primary care, and culturally and linguistically adapted health literacy strategies. Strengthening coordination between community and hospital services is also essential. By focusing on a high-risk period and a vulnerable population, the study provides actionable evidence to inform targeted interventions aimed at reducing avoidable ED use and promoting equity in neonatal healthcare delivery and outcomes.
Summary of article
This cross-sectional observational study examines patterns of pediatric emergency department (ED) use among newborns (=28 days), comparing those born to migrant and non-migrant mothers in a level II hospital in Portugal. The sample included 159 newborns, 65% of whom were children of migrant mothers. Baseline perinatal characteristics were largely comparable between groups, with the exception of a slightly older age at presentation among migrant newborns. Significant differences emerged in healthcare trajectories. Newborns of migrant mothers showed lower integration into primary care, including reduced assignment of a family physician (29% vs. 76%) and fewer scheduled consultations. They were also less frequently referred prior to ED attendance and relied more on telephone triage pathways. Clinically, most ED visits were of low acuity. The most frequent discharge category was “no disease” (43%), particularly among migrants (49%), reflecting presentations driven by benign conditions or parental concern. The leading reasons for admission were respiratory symptoms and jaundice, with no significant overall differences between groups. Despite differences in access and care pathways, hospitalization rates were similar, suggesting comparable clinical severity.

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