Semaan Aline, Grovogui Fassou Mathias, Delvaux Thérèse, Housseine Natasha, van den Akker Thomas, Delamou Alexandre, Beňová Lenka
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Centre National de Formation et de Recherche en Santé Rurale (CNFRSR) de Maférinyah, Forécariah, Guinea.
PLOS Glob Public Health. 2024 Oct 3;4(10):e0003786. doi: 10.1371/journal.pgph.0003786. eCollection 2024.
The immediate postpartum period (first 24 hours after birth) represents a critical time for women and newborns. Postnatal length-of-stay varies globally; in Guinea, a 24-hour facility stay following childbirth is recommended, with an emphasis on providing frequent monitoring of mother and newborn for the first 6 hours. This study describes postpartum length-of-stay following facility-based births in Guinea, and investigates factors associated with early discharge. This cross-sectional study analysed secondary Demographic and Health Survey data covering the most recent livebirths during 2013-2018. We included 2,763 women who gave birth vaginally or by caesarean section in healthcare facilities. Early discharge following vaginal birth was defined according to two cut-offs (<24 hours and <6 hours); early discharge following caesarean section was defined as <72 hours. We assessed socio-demographic, obstetric and health-system factors associated with early discharge using binary and multi-variable logistic regression. Among women with a vaginal birth, 81.5% were discharged <6 hours, with a median length-of-stay of 3 hours. 28% of women who had caesarean section were discharged <72 hours. Odds of discharge <6 hours among women who gave birth vaginally were lower for births in non-government hospital(aOR = 0.55[95%CI = 0.35;0.85]), and multiple births(aOR = 0.54[95%CI = 0.31;0.94]); while the odds were higher in five of the 8 regions compared to Boké. Among women who gave birth by caesarean section, odds of discharge <72 hours were lower for births in government hospitals(aOR = 0.09[95%CI = 0.03;0.3]), and girl newborns(aOR = 0.15[95%CI = 0.05;0.48]).This study showed that postpartum length-of-stays in Guinea is on average shorter than the local recommendations, with the majority of postpartum women with vaginal births spending less than 6-hours in health facilities after birth. Early discharge was associated with type of facility of birth and region. This warrants an in-depth exploration of reasons related to women's and families' preferences, health workers' practices, resource availability, and whether/how early discharge affects postpartum quality-of-care and health outcomes.
产后即时阶段（出生后的头24小时）对女性和新生儿来说是一个关键时期。全球产后住院时间各不相同；在几内亚，建议分娩后在医疗机构住院24小时，并强调在头6小时内对母亲和新生儿进行频繁监测。本研究描述了几内亚医疗机构分娩后的产后住院时间，并调查了与早期出院相关的因素。这项横断面研究分析了2013 - 2018年期间最新活产情况的二次人口与健康调查数据。我们纳入了2763名在医疗机构经阴道分娩或剖宫产的妇女。阴道分娩后的早期出院根据两个临界值定义（<24小时和<6小时）；剖宫产术后的早期出院定义为<72小时。我们使用二元和多变量逻辑回归评估了与早期出院相关的社会人口统计学、产科和卫生系统因素。在经阴道分娩的妇女中，81.5%在<6小时内出院，中位住院时间为3小时。剖宫产的妇女中有28%在<72小时内出院。阴道分娩的妇女中，在非政府医院分娩（调整后比值比[aOR]=0.55[95%置信区间（CI）=0.35；0.85]）以及多胎分娩（aOR = 0.54[95%CI = 0.31；0.94]）的妇女<6小时出院的几率较低；而与博凯相比，8个地区中有5个地区的几率较高。在剖宫产的妇女中，在政府医院分娩（aOR = 0.09[95%CI = 0.03；0.3]）以及女新生儿（aOR = 0.15[95%CI = 0.05；0.48]）的妇女<72小时出院的几率较低。本研究表明，几内亚的产后住院时间平均短于当地建议时间，大多数经阴道分娩的产后妇女在出生后在医疗机构的停留时间少于6小时。早期出院与分娩机构类型和地区有关。这需要深入探究与妇女和家庭偏好、卫生工作者做法、资源可用性以及早期出院是否/如何影响产后护理质量和健康结局相关的原因。
