Original articlesInfant mortality and early postpartum discharge☆
Section snippets
Materials and methods
We conducted a historical cohort study using data from the 1989 to 1990 Washington State Birth Event Record Database, which links birth certificate and infant death certificate records with maternal and newborn hospital discharge records. The file includes time and date of birth, date (but not time) of discharge, and sociodemographic and clinical characteristics. Approval was obtained from the RAND Human Subjects Protection Committee.
Of approximately 150,000 total births in Washington in 1989
Results
Comparisons of average maternal characteristics for the groups, such as marital status, Medicaid status, and age, indicated that newborns discharged early had significantly lower socioeconomic status than newborns with longer stays (Table 1). Other measures indicated that newborns discharged early were significantly healthier on average and that their mothers were significantly more likely to be multiparous—perhaps because second and subsequent vaginal deliveries were often easier than first.
Discussion
Based on our reading of two literature reviews3, 17 and 37 abstracts identified through the MEDLINE database (1996–1999) using the search terms “infant,” “newborn,” “postpartum,” “maternal,” “perinatal,” “birth,” “length of stay,” “early discharge,” “death,” and “mortality,” this is the first study to establish a statistically significant association between early postpartum discharge and newborn mortality. One retrospective case-control study16 and one randomized controlled trial18 found that
References (21)
- et al.
A randomized trial of a program of early postpartum discharge with nurse visitation
Am J Obstet Gynecol
(1997) - et al.
Congenital malformations presenting during the neonatal period
Clin Perinatol
(1998) - et al.
The safety of early postpartum dischargeA review and critique
Obstet Gynecol
(1997) - Centers for Disease Control and Prevention. Trends in length of stay for hospital deliveries, United States, 1970–1992....
- et al.
The Commonwealth Fund Survey of Parents With Young Children
(1996) - et al.
Problems associated with early discharge of newborn infants. Early discharge of newborns and mothersA critical review of the literature
Pediatrics
(1995) - et al.
Early and late discharge after hospital birth. Health of mother and infant in the postpartum period
Upsala J Med Sci
(1987) - et al.
Perinatal care of low-risk mothers and infants
N Engl J Med
(1976) - et al.
A randomized, controlled evaluation of early postpartum discharge
Birth
(1990) - et al.
A randomized trial of early hospital discharge and home follow-up of women having cesarean birth
Obstet Gynecol
(1994)
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This study was supported by grant R03 HS09342-01 from the Agency for Health Care Policy and Research (AHCPR). It is based on data collected under the Management and Outcomes of Childbirth Patient Outcomes Research Team (PORT), which was supported by a contract to RAND (282-90-0039) from AHCPR.