A randomized trial of a program of early postpartum discharge with nurse visitation.
OBJECTIVE
Our purpose was to compare an early postpartum discharge program versus standard postpartum care.


METHODS
A randomized controlled trial in a 637-bed university hospital included 175 healthy women recruited at 32 to 38 weeks gestation from physicians' offices and sonograms. Experimental intervention consisted of discharge 6 to 36 hours post partum with nursing care available by telephone or at home at 34 to 38 weeks' gestation and at < or = 48 hours and at 3, 5, and 10 days post partum. The control included a postpartum stay of 48 to 72 hours and standard follow-up.


RESULTS
At 1 month no significant differences were seen in perceived maternal competence (Experimental-Control = 4.3 points [95% confidence interval-7.7 to 16.3]), infant weight gain (1.2 gm/ day [-2.8 to 5.2]); identification of significant neonatal hyperbilirubinemia (rate ratio 0.50 [0.10 to 2.51]), infant utilization of health services (rate ratio 0.88 [0.45 to 1.73]), or predominant breast-feeding (adjusted odds ratio 1.25 [0.88 to 1.75]). Program participants did have significantly less frequent infant bilirubin testing (rate ratio 0.39 [0.17 to 0.94]). The program also enhanced perceived maternal competence in recent immigrants (26.9 points [2.7 to 51.5]).


CONCLUSIONS
Early postpartum discharge coupled with prenatal, postnatal, and home contacts leads to no apparent disadvantage and may yield benefits for some mothers and infants.
Gagnon
A J
AJ
Center for Nursing Research, Sir Mortimer B. Davis-Jeansh General Hospital, Montreal, Quebec, Canada.
Edgar
L
L
Kramer
M S
MS
Papageorgiou
A
A
Waghorn
K
K
Klein
M C
MC
D003152:Community Health Nursing; D005260:Female; D006699:Home Care Services; D006801:Humans; D010351:Patient Discharge; D049590:Postpartum Period; D013997:Time Factors