[Early discharge from maternity and neonatal care units--limitations and perspectives]

Early discharge from maternity units has become more frequent over the last decade. The driving forces have been historical, ideological, logistic, and financial. Often early discharge has been implemented without adequate changes in follow-up practices, resulting in increased readmission rates to hospitals. Many infants recalled for metabolic screening have not showed up, with the attending risk of mental retardation. The question of length of maternity stays has not been adequately studied. Established practice should therefore be changed cautiously. Mechanisms for quality control must be in place to ensure early detection of unanticipated problems. Early discharge from neonatal intensive care units is happening in several countries, either due to lack of equipment or bed space, or to reduce the cost of care. In wealthier countries technology-dependent infants are increasingly being cared for at home. These practices have also not been well studied, and probably should be. Of particular interest is the question of parents' ability to cope with the challenges of caring for these infants.