Home care after early discharge: Impact on healthy mothers and newborns

Askelsdóttir, Björk; Jonge, Willemien Lam-de; Edman, Gunnar; Wiklund, Ingela

doi:10.1016/j.midw.2012.11.001

Cited by 31 publications

(39 citation statements)

References 15 publications

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“…During the update process, no systematic reviews, meta-analyses, or RCTs were found. After a first sifting based on title and abstract, 16 non-randomised studies were retrieved for further analysis on full text [ 1 , 2 , 6 , 16 – 28 ]. Finally, 2 non-randomised studies were included in our review [ 16 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

Vaginal delivery: how does early hospital discharge affect mother and child outcomes? A systematic literature review

Benahmed

Miguel

Devos

et al. 2017

BMC Pregnancy Childbirth

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BackgroundThere is an international trend to shorten the postpartum length of stay in hospitals, driven by cost containment, hospital bed availability and a movement toward the ‘demedicalization’ of birth. The aim of this systematic literature review is to determine how early postnatal discharge policies from hospitals could affect health outcomes after vaginal delivery for healthy mothers and term newborns.MethodsA search for systematic reviews, meta-analyses, and primary studies was carried out in OVID MEDLINE, Embase, CINAHL, Econlit and the Cochrane Library (Cochrane Database of Systematic Reviews, DARE and HTA databases). The AMSTAR checklist was used for the quality appraisal of systematic reviews. The quality of the retrieved studies was assessed by the Cochrane Collaboration’s tools. The level of evidence was appraised using the GRADE system.ResultsSeven RCTs and two additional observational studies were found but no comprehensive economic evaluation. Despite variation in the definition of early discharge, the authors of the included studies, concerning early discharge and conventional length of stay, reported no statistical difference in maternal and neonatal morbidity, maternal and neonatal readmission rates, infant mortality, newborn weight gain, neonatal hyperbilirubinemia, or breastfeeding rates. The authors reported conflicting results regarding postpartum depression and competence of mothering, ranging from no difference according to length of stay to better results for early discharge. The level of evidence of the vast majority of outcomes was rated as low to very low.ConclusionsBecause of the lack of robust clinical evidence and full economic evaluations, the current data neither support nor discourage the widespread use of early postpartum discharge. Before implementing an early discharge policy, Western countries with longer length of hospital stay may benefit from testing shorter length of stay in studies with an appropriate design. The issue of cost containment in implementing early discharge and the potential impact on the current and future health of the population exemplifies the need for publicly funded clinical trials in such public health area. Finally, trials testing the range of out-patient interventions supporting early discharge are needed in Western countries which implemented early discharge policies in the past.

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Section: Resultsmentioning

confidence: 99%

Vaginal delivery: how does early hospital discharge affect mother and child outcomes? A systematic literature review

Benahmed

Miguel

Devos

et al. 2017

BMC Pregnancy Childbirth

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“…Quantitative effect evaluations of early postnatal discharge often use rate of readmission and breast feeding to measure the safety of early discharge (Brown et al, 2002;Askelsdottir et al, 2013). Results are possibly influenced by substantial variation in antenatal preparation, timing of early discharge and follow up (Bravo et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…A growing number of qualitative studies on parents' experiences of early postnatal discharge reveal knowledge of new parents' need for support and information during the short hospitalisation as well as the first week after discharge (Persson and Dykes, 2002;Askelsdottir et al, 2013;Danbjorg et al, 2014). This knowledge might improve the quality of postnatal care.…”

Section: Introductionmentioning

confidence: 99%

Parental experiences of early postnatal discharge: A meta-synthesis

et al. 2015

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“…Dermed kan hun håndtere sin nye livssituasjon på en bedre måte og selv ha makt, styring og kontroll i situasjonen (27,28). Studien synes å vise at oppmerksomhet på individuelle behov og mestring bidro til å fremme empowerment hos kvinnen, hvilket er sammenfallende med funn i andre studier (8,9,29).…”

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