title: The effect of early postnatal discharge from hospital for women and infants: a systematic review protocol.
abstract: BACKGROUND
  The length of postnatal hospital stay has declined over the last 40 years. There is little evidence to support a policy of early discharge following birth, and there is some concern about whether early discharge of mothers and babies is safe. The Cochrane review on the effects of early discharge from hospital only included randomised controlled trials (RCTs) which are problematic in this area, and a systematic review including other study designs is required. The aim of this broader systematic review is to determine possible effects of a policy of early postnatal discharge on important maternal and infant health-related outcomes.
  
  
  METHODS
  A systematic search of published literature will be conducted for randomised controlled trials, non-randomised controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series studies (ITS) that report on the effect of a policy of early postnatal discharge from hospital. Databases including Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL and Science Citation Index will be searched for relevant material. Reference lists of articles will also be searched in addition to searches to identify grey literature. Screening of identified articles and data extraction will be conducted in duplicate and independently. Methodological quality of the included studies will be assessed using the Effective Practice and Organisation of Care (EPOC) criteria for risk of bias tool. Discrepancies will be resolved by consensus or by consulting a third author. Meta-analysis using a random effects model will be used to combine data. Where significant heterogeneity is present, data will be combined in a narrative synthesis. The findings will be reported according to the preferred reporting items for systematic reviews (PRISMA) statement.
  
  
  CONCLUSIONS
  Information on the effects of early postnatal discharge from hospital will be important for policy makers and clinicians providing maternity care. This review will also identify any gaps in the current literature on this topic and provide direction for future research in this area of study.
  
  
  BACKGROUND
  PROSPERO CRD42015020545.
authors: Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. exj480@student.bham.ac.uk.
authors: Eleanor
authors: E
authors: Jones
authors: Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. R.Taylor.3@bham.ac.uk.
authors: Beck
authors: B
authors: Taylor
authors: Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. C.MACARTHUR@bham.ac.uk.
authors: Christine
authors: C
authors: MacArthur
authors: Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. R.V.Blamey@bham.ac.uk.
authors: Ruth
authors: R
authors: Pritchett
authors: Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. C.L.CUMMINS@bham.ac.uk.
authors: Carole
authors: C
authors: Cummins
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D000078202:Systematic Reviews as Topic; D013997:Time Factors