Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study.

Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study. Research Abstract Details 

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Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study. Abstract Text:

Henry H Bernstein,Cathie Spino,Stacia Finch,Richard Wasserman,Eric Slora,Christina Lalama,Carol Litten Touloukian,Harris Lilienfeld,Marie C McCormick,

OBJECTIVES: Postpartum discharge of mothers and infants who are not medically or psychosocially ready may place the family at risk. Most studies of postpartum length of stay, however, do not reflect the necessary complexity of decision-making. With this study we aimed to characterize decision-making on the day of postpartum discharge from the perspective of multiple key informants and identify correlates of maternal and newborn unreadiness for discharge. PATIENTS AND METHODS: This was a prospective observational cohort study of healthy term infants with mothers, pediatric providers, and obstetricians as key informants to assess the decision-making process regarding mother-infant dyad unreadiness for discharge. A mother-infant dyad was defined as unready for postpartum hospital discharge if > or = 1 of 3 informants perceived that either the mother or infant should stay longer at time of nursery discharge. Data were collected through self-administered questionnaires on the day of discharge. RESULTS: Of 4300 mother-infant dyads, unreadiness was identified in 17% as determined by the mother (11%), pediatrician (5%), obstetrician (1%), and > or = 2 informants (< 1%). Significant correlates of unreadiness were as follows: black non-Hispanic maternal race/ethnicity, maternal history of chronic disease, primigravid status, inadequate prenatal care as determined by the Kotelchuck Adequacy of Prenatal Care Utilization Index, delivering during nonroutine hours, in-hospital neonatal problems, receiving a limited number of in-hospital classes, and intent to breastfeed. CONCLUSIONS: Mothers, pediatricians, and obstetricians must make decisions about postpartum discharge jointly, because perceptions of unreadiness often differ. Sensitivity toward specific maternal vulnerabilities and an emphasis on perinatal education to insure individualized discharge plans may increase readiness and determine optimal timing for discharge and follow-up care.

Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study. Publishing Authors By Initials

HH Bernstein,C Spino,S Finch,R Wasserman,E Slora,C Lalama,CL Touloukian,H Lilienfeld,MC McCormick,

For similar investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: cohort studies: longitudinal studies: prospective studies research abstracts see: investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: cohort studies: longitudinal studies: prospective studies research

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Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Pediatrics

VOLUME: 120

Page Numbers: e391-400

Journal Abbreviation: Pediatrics

ISSN: 1098-4275

DAY: 16

MONTH: 07

YEAR: 2007

Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study. Information

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LANGUAGE: eng

NlmUniqueID: 376422

Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study. Keywords Mesh Terms:

KEYWORDS: Prospective Studies

MESH TERMS: psychology

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Grant and Affiliation Information for Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study.

AFFILIATION: Department of Pediatrics, Dartmouth Medical School, Children's Hospital at Dartmouth, Lebanon, New Hampshire 03756-0001, USA. henry.bernstein@hitchcock.org

Country: United States

AGENCY: United States PHS

GRANT: 5 R40 MC00117

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MEDLINETA: Pediatrics

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