Gagnon A J, Edgar L, Kramer M S, Papageorgiou A, Waghorn K, Klein M C
Center for Nursing Research, Sir Mortimer B. Davis-Jeansh General Hospital, Montreal, Quebec, Canada.
Am J Obstet Gynecol. 1997 Jan;176(1 Pt 1):205-11. doi: 10.1016/s0002-9378(97)80037-3.
Our purpose was to compare an early postpartum discharge program versus standard postpartum care.
A randomized controlled trial in a 637-bed university hospital included 175 healthy women recruited at 32 to 38 weeks gestation from physicians' offices and sonograms. Experimental intervention consisted of discharge 6 to 36 hours post partum with nursing care available by telephone or at home at 34 to 38 weeks' gestation and at < or = 48 hours and at 3, 5, and 10 days post partum. The control included a postpartum stay of 48 to 72 hours and standard follow-up.
At 1 month no significant differences were seen in perceived maternal competence (Experimental-Control = 4.3 points [95% confidence interval-7.7 to 16.3]), infant weight gain (1.2 gm/ day [-2.8 to 5.2]); identification of significant neonatal hyperbilirubinemia (rate ratio 0.50 [0.10 to 2.51]), infant utilization of health services (rate ratio 0.88 [0.45 to 1.73]), or predominant breast-feeding (adjusted odds ratio 1.25 [0.88 to 1.75]). Program participants did have significantly less frequent infant bilirubin testing (rate ratio 0.39 [0.17 to 0.94]). The program also enhanced perceived maternal competence in recent immigrants (26.9 points [2.7 to 51.5]).
Early postpartum discharge coupled with prenatal, postnatal, and home contacts leads to no apparent disadvantage and may yield benefits for some mothers and infants.
我们的目的是比较早期产后出院计划与标准产后护理。
在一家拥有637张床位的大学医院进行的一项随机对照试验，纳入了175名健康女性，她们在妊娠32至38周时从医生办公室和超声检查中招募而来。实验性干预包括产后6至36小时出院，并在妊娠34至38周、产后≤48小时、3天、5天和10天提供电话或家庭护理。对照组包括产后住院48至72小时及标准随访。
在1个月时，在感知到的母亲能力方面未见显著差异（实验组 - 对照组 = 4.3分[95%置信区间 -7.7至16.3]），婴儿体重增加（1.2克/天[-2.8至5.2]）；显著新生儿高胆红素血症的识别（率比0.50[0.10至2.51]），婴儿对医疗服务的利用（率比0.88[0.45至1.73]），或纯母乳喂养（调整后的优势比1.25[0.88至1.75]）。该计划的参与者婴儿胆红素检测频率显著较低（率比0.39[0.17至0.94]）。该计划还提高了新移民母亲的感知能力（26.9分[2.7至51.5]）。
早期产后出院加上产前、产后和家庭联系不会导致明显的不利影响，并且可能对一些母亲和婴儿有益。
