EARLY DISCHARGE OF NEWBORNS AND MOTHERS - A CRITICAL-REVIEW OF THE LITERATURE

Objective. To determine whether research supports the advisability of early discharge of healthy newborns and mothers. Methods. Critical rev iew of English-language literature cited in the Inner Medicus or the I nternational Nursing Index. Findings. No adequately designed studies h ave examined discharge before 48 hours after delivery without addition al postdischarge services. Few studies have examined the consequences of recommending a clinic visit within the first days after discharge; studies of this practice among low-income populations found high no-sh ow rates. Some small studies suggest that early discharge is likely to be safe for selected populations at low psychosocial, socioeconomic, and medical risk, with careful antenatal screening and preparation and multiple postpartum home visits. Some studies suggested adverse outco mes associated with early discharge even with early follow-up. Conclus ions. Published research provides little knowledge of the consequences of short maternal/newborn hospital stays or varying postdischarge pra ctices for the general population. The studies that have concluded tha t early discharge was safe were applied under restricted circumstances or were too small to detect clinically significant effects on importa nt outcomes. Further research is needed to inform clinical and reimbur sement policy on health services in the first days of life and parenti ng. Rigorous studies of sufficient size are needed to examine the impa ct of different hospital stays and different postdischarge practices o n a range of outcomes for mothers and newborns in diverse populations and settings. Given a priori concerns, decisions on neonatal/obstetric discharge planning should be made cautiously.