Clinical and Evaluative Epidemiology Department, Trento Health Service, Viale Verona, 38123, Trento, Italy.
Neonatal Unit, Trento Health Service, Largo Medaglie d'Oro 9, 38122, Trento, Italy.
Eur J Pediatr. 2018 Jan;177(1):155-159. doi: 10.1007/s00431-017-3035-4. Epub 2017 Nov 7.
Early discharge (ED) of healthy term infants has become a common practice due to current social and economic needs. The primary objective of the present study was to evaluate trends in early discharge of healthy term neonates (≥ 37 gestational weeks) by delivery method (cesarean and vaginal) in maternity units in the Province of Trento. The secondary objective was to identify the socio-demographic characteristics (including the area of residence and distance from the designated hospital) and clinical characteristics of mothers whose infants were discharged early. This retrospective study reviewed records of live births from 2006 to 2016, for a total of 45, 314 healthy term infants. The trend for ED grew significantly during the period 2006-2016, for both cesarean and vaginal deliveries. The multiple logistic regression analysis shows how the determinants of ED are maternal age, birth order, citizenship of mother, maternal smoking, maternal employment status, and the number of births at the hospital on the day of birth.
The post-partum length of stay should be adjusted based on the characteristics and needs of the mother-infant dyad, identifying the criteria for safe discharge. In Trento, various procedures and programs are becoming more uniform today with the intention to provide family assistance service. What is Known: • Admission for childbirth is one of the primary causes of hospitalization in industrialized countries. • The length of stay for childbirth has been steadily declining in recent decades, with the aim of reducing costs while also demedicalizing pregnancy. What is New: • A higher rate of early discharge (ED) was recorded for neonates of women having foreign citizenship, < 30 years, pluriparous, smoked during pregnancy, housewife, and, if emplyed, entrepreneurs, self-employed professionals or managers. • ED was more common when the new mother gave birth on a day in which there was a higher number of births at the hospital, indicating overcrowding in the maternity unit.
由于当前的社会和经济需求，健康足月婴儿的早期出院（ED）已成为一种常见做法。本研究的主要目的是评估特伦托省产科病房中通过分娩方式（剖宫产和阴道分娩）的健康足月新生儿（≥37 孕周）早期出院的趋势。次要目的是确定其婴儿早期出院的母亲的社会人口统计学特征（包括居住地和距指定医院的距离）和临床特征。这项回顾性研究回顾了 2006 年至 2016 年的活产记录，共有 45314 名健康足月婴儿。2006-2016 年期间，剖宫产和阴道分娩的 ED 趋势均显著增长。多变量逻辑回归分析显示 ED 的决定因素是母亲年龄、分娩顺序、母亲国籍、母亲吸烟、母亲就业状况以及分娩当天医院的出生人数。
应根据母婴对的特征和需求调整产后住院时间，确定安全出院的标准。在特伦托，如今各种程序和方案变得更加统一，旨在提供家庭援助服务。
分娩住院是工业化国家住院的主要原因之一。
近几十年来，分娩的住院时间稳步下降，目的是降低成本，同时使妊娠非医学化。
记录到具有外国公民身份、<30 岁、多胎、怀孕期间吸烟、家庭主妇、如果就业、企业家、自营职业专业人员或管理人员的母亲所生的新生儿早期出院率较高。
当新妈妈在医院分娩人数较多的日子分娩时，ED 更为常见，这表明产科病房过于拥挤。
