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[Early postpartum hospital discharge in France]
F Vendittelli1, M Boniol, N Mamelle
1INSERM-UCLB UMR 369, Groupe "Epidemiologie de la croissance et du développement" Faculté de Médecine RTH Laennec, 8, rue Guillaume-Paradin, 69372 Lyon. fvendittelli@chu-clermontferrand.fr
Background:
Early postpartum discharge is a recent practice in France and for which there are few national data.
Methods:
The Sentinel AUDIPOG network was used to describe the practice of postpartum early discharge (< 3 days in case of vaginal delivery and < 5 days in case of caesarean section) from 1994 till 2002, after standardization on the distribution according to the type of hospital and the region (n = 128232). Secondarily, the prognostic medical factors of an early postpartum hospital discharge were researched, in univariate analysis and logistic regression analysis, of the births of 2001-2002.
Results:
Early postpartum discharges concerned 3% of the deliveries in 1997 and 7% in 2002. Eearly postpartum discharge was more frequent in the level II and III obstetric facilities, in non- university hospitals, in facilities with more than 1 500 deliveries a year, in urban hospitals and in Paris and the surrounding area. The women leaving early in the postpartum were more often multiparas, with no pregnancy pathology, with a single pregnancy, without postpartum hemorrhage, and a child > 2500 g without risk of infection. At present, 40% of vaginal delivery and 25% of caesarean section primiparas and 55% of vaginal delivery and 30% of caesarean section multiparas could be discharged early.
Conclusion:
The reduction of the postpartum hospital stay is inevitable but it is advisable to take care that the women who are discharged are medically fit for discharge.
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