[Early post-partum discharge of mother and child: a literature review].
This review summarises data on the relationship between the duration of postnatal hospital stay and neonatal outcome for term and preterm infants. Almost all of the data available derive from observational studies and should thus be interpreted with caution. For term infants, several studies found an increase in readmission rates in infants discharged early; in one of these studies, hospital discharge at less than 30 hours post partum was associated with an increase of neonatal mortality by almost four times. These risks may be reduced by establishing a rigorous follow-up program including home visits, for example, by a midwife. Disadvantages concerning mother-infant interaction or breast feeding success have not yet been demonstrated. For preterm infants, two randomised studies showed substantial cost savings due to an early discharge program involving home visits and telephone contacts, while there was no increase in the rate of readmissions or other complications. Translated into the German setting, these data suggest a way of reducing the length of hospital stay for both term and preterm neonates and their mothers without compromising their outcome, a goal that may become even more relevant with the imminent introduction of a reimbursement system based on diagnosis-related groups (DRGs).
Poets
Christian F
CF
Abteilung für Neonatologie, Universitätsklinikum Tübingen. Christian-F.Poets@med.uni-tuebingen.de
Harms
Karsten
K
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D010351:Patient Discharge; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy