Safety and Cost-Effectiveness of Early Maternal Newborn Infant Discharge

February 19, 2015 updated by: William H. Barth, Jr., M.D., Col(ret), USAF, MC, 59th Medical Wing

A Randomized Controlled Trial to Assess the Safety and Cost-Effectiveness of Early Maternal Newborn Infant Discharge

To determine the effect of a policy of early maternal-newborn infant discharge (12-24 hours) with a home visit on admission to the Level II/III nursery and hospital admissions and readmissions.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This is a randomized controlled trial designed to assess the safety of a policy of early maternal newborn infant discharge compared to a policy of routine discharge 2 to 3 days after delivery. The primary outcome is newborn admissions to the Level II or Level III neonatal care unit or hospital within three days of delivery. Secondary outcomes included admissions and readmissions at 2 weeks, 6 weeks and 6 months following delivery, maternal satisfaction with length of stay and overall birthing experience, lactation continuation rates, maternal anxiety, depression, confidence and family functioning. We applied the American Academy of Pediatrics criteria for early newborn discharge, but planned the analysis by intention to treat.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
2223

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • All pregnant women enrolling for obstetric care at a large military academic health center

Exclusion Criteria:

  • Planning a move from the area before delivery
  • Multiple gestations
  • Pre-existing maternal diabetes
  • Maternal chronic hypertension
  • Maternal age < 18

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Early Discharge Group
If safety criteria were met, women and infants were discharged home from the hospital at 12 to 24 hours after delivery with a planned home health visit within 48 hours of the discharge.
Other: Early Maternal-Newborn Infant Discharge
Discharge from the hospital between 12-24 hours of life
Active Comparator: Routine Stay Group
Women and newborns were discharged no sooner than 48 hours after delivery and could stay voluntarily up to 72 hours.
Other: Routine discharge
Discharge of the mother and newborn 2 to 3 days after delivery

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Admission to the Level II/III neonatal care unit or hospital
Time Frame: 72 hours
All admissions to the Level II/III neonatal care unit following delivery
72 hours

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Emergency department visits, clinic visits, or hospital admissions
Time Frame: 72 hours
Any unplanned pediatric visit to an emergency room, clinic or a hospital admission
72 hours
Emergency department visits, clinic visits, or hospital admissions
Time Frame: 14 days
Any unplanned pediatric visit to an emergency room, clinic or a hospital admission
14 days
Emergency department visits, clinic visits, or hospital admissions
Time Frame: 8 weeks
Any unplanned pediatric visit to an emergency room, clinic or a hospital admission
8 weeks
Emergency department visits, clinic visits, or hospital admissions
Time Frame: 6 months
Any unplanned pediatric visit to an emergency room, clinic or a hospital admission
6 months
Breastfeeding score (5 point Likert scale)
Time Frame: At discharge (12 to 72 hours after delivery)
5 point Likert scale: Only breast, mostly breast, 50/50, mostly bottle, only bottle
At discharge (12 to 72 hours after delivery)
Breastfeeding score (5 point Likert scale)
Time Frame: 14 days
5 point Likert scale: Only breast, mostly breast, 50/50, mostly bottle, only bottle
14 days
Breastfeeding score (5 point Likert scale)
Time Frame: 8 weeks
5 point Likert scale: Only breast, mostly breast, 50/50, mostly bottle, only bottle
8 weeks
Breastfeeding score (5 point Likert scale)
Time Frame: 6 months
5 point Likert scale: Only breast, mostly breast, 50/50, mostly bottle, only bottle
6 months
Maternal anxiety (State/Trait Anxiety Inventory)
Time Frame: At discharge (12 to 72 hours after delivery)
At discharge (12 to 72 hours after delivery)
Maternal anxiety (State/Trait Anxiety Inventory)
Time Frame: 14 days
State/Trait Anxiety Inventory
14 days
Maternal depression (Generalized Contentment Scale)
Time Frame: At discharge (12 to 72 hours after delivery)
Generalized Contentment Scale
At discharge (12 to 72 hours after delivery)
Maternal depression (Generalized Contentment Scale)
Time Frame: 14 days
Generalized Contentment Scale
14 days
Maternal confidence (Confidence on a Likert scale)
Time Frame: At discharge (12 to 72 hours after delivery)
Confidence on a Likert scale
At discharge (12 to 72 hours after delivery)
Maternal confidence (Confidence on a Likert scale)
Time Frame: 14 days
Confidence on a Likert scale
14 days
Maternal satisfaction with length of stay (Likert scale)
Time Frame: At discharge (12 to 72 hours after delivery)
Satisfaction with length of stay on a Likert scale
At discharge (12 to 72 hours after delivery)
Maternal satisfaction with length of stay (Likert scale)
Time Frame: 14 days
Satisfaction with length of stay on a Likert scale
14 days
Maternal satisfaction with overall experience (Likert scale)
Time Frame: At discharge (12 to 72 hours after delivery)
Satisfaction with overall childbirth experience on a Likert scale
At discharge (12 to 72 hours after delivery)
Maternal satisfaction with overall experience (Likert scale)
Time Frame: 14 days
Satisfaction with overall childbirth experience on a Likert scale
14 days
Admission to the Level II/III neonatal care unit or hospital
Time Frame: 14 days
All admissions to the Level II/III neonatal care unit following delivery
14 days
Admission to the Level II/III neonatal care unit or hospital
Time Frame: 8 weeks
All admissions to the Level II/III neonatal care unit following delivery
8 weeks
Admission to the Level II/III neonatal care unit or hospital
Time Frame: 6 months
All admissions to the Level II/III neonatal care unit following delivery
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
59th Medical Wing

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: William H Barth, MD, Massachusetts General Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 1, 1997

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 1, 2001

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 1, 2001

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 3, 2015

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 19, 2015

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 26, 2015

Study Record Updates

Last Update Posted (Estimate)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
February 26, 2015

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 19, 2015

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2015

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • SGO 96-042
  • DI950076 (Other Grant/Funding Number: Department of Defense Women's Health Intramural Research)
  • FWH19960042H (Other Identifier: Wilford Hall Medical Center)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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