Hospital discharge on the first compared with the second day after a planned cesarean delivery: a randomized controlled trial

Obstet Gynecol. 2012 Dec;120(6):1273-82. doi: 10.1097/aog.0b013e3182723a95.

Abstract

Objectives: To compare patient satisfaction and exclusive breastfeeding rates for patients discharged from the hospital on postcesarean day 1 (next day) or day 2.

Methods: Healthy women admitted for planned cesarean delivery were randomized to day 1 or day 2 discharge. Postoperative assessment for suitability for discharge was based on defined criteria. Primary outcomes were patient satisfaction with their discharge timing assessed at 2 weeks and reported exclusive breastfeeding at 6 weeks after discharge. Analyses were based on intention-to-treat and per-protocol discharge.

Results: Of the 360 women randomized, results of 170 compared with 172 and 142 compared with 148 (day 1 compared with day 2) were available for intention-to-treat and per-protocol analyses, respectively. Nine women fulfilled discharge criteria but declined day 1 discharge, and 12 women allocated to day 2 discharge took their own discharge on day 1. Intention-to-treat analysis showed that satisfaction with discharge protocol was expressed by 148 of 170 (87.1%) compared with 147 of 172 (85.5%) (relative risk 1.1, 95% confidence interval [CI] 0.6-2.1, P=.75) and exclusive breastfeeding (at 6 weeks) was reported by 76 of 170 (44.7%) compared with 77 of 172 (44.9%) (relative risk 1.0 95% CI 0.7-1.5 P=.99 for day 1 compared with day 2 discharges, respectively). All secondary outcomes assessed at up to 6 weeks after discharge including unscheduled maternal or infant medical consultations, rehospitalizations, maternal antibiotic use, and maternal well-being, anxiety, and depression status, were similar. Results on per-protocol analysis were also similar.

Conclusion: Day 1 discharge compared with day 2 discharge after a planned cesarean delivery resulted in equivalent outcomes.

Clinical trial registration: ISRCTN Register, ISRCTN.org, ISRCTN27523895.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / psychology
  • Breast Feeding / psychology
  • Cesarean Section / psychology*
  • Depression / psychology
  • Female
  • Humans
  • Infant, Newborn
  • Maternal Welfare / psychology
  • Patient Discharge*
  • Patient Readmission
  • Patient Satisfaction*
  • Pregnancy
  • Treatment Outcome

Associated data

  • ISRCTN/ISRCTN27523895