Early discharge from maternity ward in response to the COVID-19 pandemic: Impact on emergency attendance

Abstract

Background: In response to the coronavirus disease 2019 (COVID-19) epidemic, our maternity department had to rapidly implement a protocol for early postpartum discharge. We evaluated the benefits and risks of early postpartum discharge.

Methods: We performed an observational, single-center case-control study over a 3 month-period during the COVID-19 outbreak (from June 1 to August 31, 2020), following implementation of the early discharge policy. Newborns were classified into an early discharge group (within 48-72 h of a vaginal delivery and within 72-96 h of a cesarean delivery) or a standard discharge group (more than 72 h after a vaginal delivery and more than 96 h after a cesarean delivery). The primary outcome measure was inappropriate pediatric emergency department visits within 28 days of delivery.

Results: A total of 546 newborns were included. A total of 22 (8.9%) of the 246 newborns in the early discharge group attended the pediatric emergency department vs. 30 (10.0%) of the 300 newborns in the standard discharge group (p = 0.65). Nine visits (40.9%) were considered inappropriate in the early discharge group vs. 13 (43.3%) in the standard discharge group (p = 0.83). Likewise, the intergroup difference in the hospital readmission rate was not statistically significant.

Discussion: The implementation of early discharge and early follow-up did not result in a significantly greater need (vs. standard discharge) for inappropriate emergency visit or hospital readmission during the first 28 days postpartum, regardless of the parity and breastfeeding status.

Keywords: COVID-19; Discharge; Emergency; Maternity; Newborn.

Fig. 1

Study flowchart *Digestive signs and symptoms: gastroesophageal reflux, diarrhea, and constipation **Neurologic signs and symptoms: seizures and an increase in cranial circumference ***Respiratory symptoms: rhinorrhea and dyspnea.