Jones Eleanor, Taylor Beck, MacArthur Christine, Pritchett Ruth, Cummins Carole
Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Syst Rev. 2016 Feb 8;5:24. doi: 10.1186/s13643-016-0193-9.
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/DESIGN: 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.
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.
PROSPERO CRD42015020545.
在过去40年里，产后住院时间有所缩短。几乎没有证据支持出生后早期出院的政策，且有人担心母婴早期出院是否安全。Cochrane关于早期出院影响的综述仅纳入了随机对照试验（RCT），而该领域的随机对照试验存在问题，因此需要一项包括其他研究设计的系统综述。这项更广泛的系统综述的目的是确定产后早期出院政策对母婴重要健康相关结局的可能影响。
方法/设计：将对已发表文献进行系统检索，以查找报告产后早期出院政策效果的随机对照试验、非随机对照试验（NRCT）、前后对照研究（CBA）和中断时间序列研究（ITS）。将检索包括Cochrane CENTRAL、MEDLINE、EMBASE、CINAHL和科学引文索引在内的数据库以获取相关资料。除了搜索以识别灰色文献外，还将搜索文章的参考文献列表。将对识别出的文章进行重复和独立的筛选及数据提取。将使用有效实践与护理组织（EPOC）偏倚风险工具标准评估纳入研究的方法学质量。差异将通过共识解决或咨询第三位作者。将使用随机效应模型进行荟萃分析以合并数据。若存在显著异质性，则将数据合并进行叙述性综合分析。研究结果将根据系统综述的首选报告项目（PRISMA）声明进行报告。
关于产后早期出院影响的信息对于提供孕产妇护理的政策制定者和临床医生而言至关重要。本综述还将识别当前关于该主题的文献中的任何空白，并为该研究领域的未来研究提供方向。
PROSPERO CRD42015020545。
