Early discharge following birth - What characterises mothers and newborns?
BACKGROUND
Early postnatal discharge has increased over the past 50 years and today we lack the knowledge on who is discharged early that would allow us to improve quality of postnatal care. The aim of this study was to describe maternal and infant predictors for early postnatal discharge in a country with equal access to health care.


METHODS
An observational study of 2786 mothers, recruited in pregnancy was conducted from April 2013 to August 2014 in four of the five regions in Denmark. Data were analysed using Kaplan-Meier method and multinomial regression models. Outcome variable was time of discharge after birth.


RESULTS
In total 34% mothers were discharged within 12 hours (very early) and 25% between 13 and 50 hours (early), respectively. Vaginal birth and multiparity were the most influential predictors, as Caesarean section compared to vaginal birth had an OR of 0.35 (CI 0.26-0.48) and primiparous compared to multiparous had an OR of 0.22 (CI 0.17-0.29) for early discharge. Other predictors for early discharge were: no induction of labour, no epidural painkiller, bleeding less than 500 ml during delivery, higher gestational age, early expected discharge and positive breastfeeding experience. Smoking, favourable social support and breastfeeding knowledge were significantly associated with discharge within 12 hours. Finally time of discharge varied significantly according to region and time of day of birth.


CONCLUSIONS
Parity and birth related factors were the strongest predictors of early discharge. Psycho-social predictors indicate that the parents are involved in the decision of when to be discharge.
The Danish Committee for Health Education, Copenhagen, Denmark; Department of Public Health, Section of Nursing, Aarhus University, Aarhus, Denmark; Department of Public Health, Section of Social Medicine, Copenhagen University, Copenhagen, Denmark. Electronic address: in@sundkom.dk.
Ingrid M S
IM
Nilsson
Department of Public Health, Section of Nursing, Aarhus University, Aarhus, Denmark.
Hanne
H
Kronborg
Institute of Veterinary Clinical and Animal Sciences, Copenhagen University, Copenhagen, Denmark.
Christopher H
CH
Knight
Department of Public Health, Section of Social Medicine, Copenhagen University, Copenhagen, Denmark.
Katrine
K
Strandberg-Larsen
D000328:Adult; D001942:Breast Feeding; D036861:Delivery, Obstetric; D003718:Denmark; D005260:Female; D005865:Gestational Age; D000069576:Health Equity; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D007902:Length of Stay; D009035:Mothers; D010298:Parity; D036801:Parturition; D010351:Patient Discharge; D011247:Pregnancy; D047928:Premature Birth; D012907:Smoking; D012944:Social Support; D047929:Term Birth; D014592:Uterine Hemorrhage; D055815:Young Adult
Characteristics; Early discharge; Mother; Post partum; Predictor