Pregnancy
Conditions
Keywords
Infant, Newborn, hospital discharge, Early newborn discharge, Newborn length of stay, Maternity length of stay
Brief summary
To determine the effect of a policy of early maternal-newborn infant discharge (12-24 hours) with a home visit on admission to the Level II/III nursery and hospital admissions and readmissions.
Detailed description
This is a randomized controlled trial designed to assess the safety of a policy of early maternal newborn infant discharge compared to a policy of routine discharge 2 to 3 days after delivery. The primary outcome is newborn admissions to the Level II or Level III neonatal care unit or hospital within three days of delivery. Secondary outcomes included admissions and readmissions at 2 weeks, 6 weeks and 6 months following delivery, maternal satisfaction with length of stay and overall birthing experience, lactation continuation rates, maternal anxiety, depression, confidence and family functioning. We applied the American Academy of Pediatrics criteria for early newborn discharge, but planned the analysis by intention to treat.
Interventions
OTHEREarly Maternal-Newborn Infant Discharge
Discharge from the hospital between 12-24 hours of life
OTHERRoutine discharge
Discharge of the mother and newborn 2 to 3 days after delivery
Sponsors
59th Medical Wing
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* All pregnant women enrolling for obstetric care at a large military academic health center
Exclusion criteria
* Planning a move from the area before delivery * Multiple gestations * Pre-existing maternal diabetes * Maternal chronic hypertension * Maternal age \< 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Admission to the Level II/III neonatal care unit or hospital | 72 hours | All admissions to the Level II/III neonatal care unit following delivery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Breastfeeding score (5 point Likert scale) | At discharge (12 to 72 hours after delivery) | 5 point Likert scale: Only breast, mostly breast, 50/50, mostly bottle, only bottle |
| Maternal anxiety (State/Trait Anxiety Inventory) | At discharge (12 to 72 hours after delivery) | — |
| Maternal depression (Generalized Contentment Scale) | At discharge (12 to 72 hours after delivery) | Generalized Contentment Scale |
| Emergency department visits, clinic visits, or hospital admissions | 72 hours | Any unplanned pediatric visit to an emergency room, clinic or a hospital admission |
| Maternal satisfaction with length of stay (Likert scale) | At discharge (12 to 72 hours after delivery) | Satisfaction with length of stay on a Likert scale |
| Maternal satisfaction with overall experience (Likert scale) | At discharge (12 to 72 hours after delivery) | Satisfaction with overall childbirth experience on a Likert scale |
| Admission to the Level II/III neonatal care unit or hospital | 14 days | All admissions to the Level II/III neonatal care unit following delivery |
| Maternal confidence (Confidence on a Likert scale) | At discharge (12 to 72 hours after delivery) | Confidence on a Likert scale |
Outcome results
None listed