Introduction: A recent Australian cohort study demonstrated an increased risk of postnatal depression in mothers discharged early from hospital after childbirth1. This finding has not been replicated in other controlled studies. This study was designed to explore this issue.

Methods: The design was a population based, prospective cohort study of ACT residents. Women completed questionnaires on Day 4, and 8, 16, and 24 weeks postpartum. Early discharge was defined as discharge within 72 hours. Postnatal depression symptoms were assessed using the 10-item Edinburgh Postnatal Depression Scale (EPDS).

Results: 1295 women participated. 1254 (96.8%) completed the second, 1221 (94.3%) the third and 1193 (92.1%) the fourth questionnaire. Overall, 129 (10.3%) of the participants scored >12 on the EPDS at 8 weeks, 91 (7.5%) at 16 weeks and 90 (7.6%) at 24 weeks postpartum. Excluding women with missing data, 455 women (36.5%) were discharged early and 790 (63.5%) after 3 days. Women discharged early were not more likely to score >12 on the EPDS than women discharged later. This was true at either 8 weeks (9.7% versus 10.7%; OR=0.90, 95%CI 0.62-1.31), 16 weeks (6.9% versus 7.6%; OR=0.91, 95%CI 0.57-1.43), or 24 weeks postpartum (6.1% versus 8.4%; OR=0.71, 95%CI 0.44-1.10). After adjusting for potential confounding factors in a multivariable logistic regression model there was still no significant association between early discharge and postnatal depression.

Conclusions: There is no evidence from this study that early discharge after childbirth increases the risk of postnatal depression.

1. Hickey AR, Boyce PM, Ellwood D, Morris-Yates AD. Early discharge and risk for postnatal depression. Medical Journal of Australia 1997;167.244-247.