Table 1_Effectiveness of discharge planning interventions on health-related outcomes among postpartum women: a systematic review and meta-analysis.docx

BackgroundPostpartum women frequently experience psychological distress, physical morbidities, and sub-optimal maternal–neonatal care skills. Structured discharge planning may mitigate these problems, yet its overall effectiveness and the active ingredients underpinning benefit remain unclear.
ObjectiveTo synthesis randomized and quasi-experimental evidence on the effectiveness of discharge planning interventions for improving postpartum women’s health outcomes and to identify intervention characteristics that modify this effectiveness.
MethodsNine electronic databases (including PubMed, Web of Science, PsycINFO, CINAHL, EMBASE, Cochrane Library, CNKI, Wanfang, and SinoMed) were searched from inception to 10 May 2025. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating discharge planning interventions aimed at postpartum women were eligible. Two reviewers independently screened records, assessed risk of bias using the Cochrane RoB 2.0 and ROBINS-I tools, and extracted data. The odds ratio (OR) with its 95% confidence interval (CI) was used as the primary statistical measure. For continuous variables, the standardized mean difference (SMD) was used. Statistical heterogeneity was quantified using the I2 statistic.
ResultsTwenty-one studies (13 RCTs and 8 quasi-experimental studies) involving 33,096 participants from nine countries were included. Discharge planning produced moderate-to-large improvements in: mental health – depressive symptoms (SMD = −0.64; 95% CI: −1.27, −0.01) and anxiety (SMD = −1.29; 95% CI: −2.22, −0.37); self-care and neonatal-care competence (OR = 2.34; 95% CI: 1.20, 4.58); and breastfeeding self-efficacy (SMD = 2.86; 95% CI: 1.63, 4.08). Interventions integrating predischarge education, post-discharge telephone follow-up, and information-based communication platforms tended to demonstrate larger effect sizes.
ConclusionThis systematic review and meta-analysis indicates that structured discharge planning programs implemented in hospital-based maternity wards during the early postpartum period can improve maternal mental health, self-care capacity, and maternal–neonatal outcomes. The evidence, derived from both randomized controlled trials and pragmatic quasi-experimental studies conducted in routine clinical settings, suggests that ward- or institution-level discharge interventions are effective and scalable strategies for optimizing postnatal transitions.
Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251055810, registered 20/05/2025.

产后妇女常出现心理困扰、躯体疾病，且母婴护理技能欠佳。结构化出院计划或可缓解上述问题，但其整体有效性及支撑其获益的核心活性成分仍尚不明确。

本研究旨在综合评估针对产后妇女的出院计划干预措施的有效性相关随机及类实验证据，并明确可调节该干预效果的干预特征。

本研究检索了9个电子数据库（包括PubMed、Web of Science、PsycINFO、CINAHL、EMBASE、Cochrane图书馆、中国知网(CNKI)、万方数据(Wanfang)、中国生物医学文献服务系统(SinoMed)），检索时限从各数据库建库至2025年5月10日。纳入针对产后妇女的出院计划干预措施的随机对照试验(randomized controlled trial, RCT)和类实验研究。由2名研究者独立筛选文献、采用Cochrane偏倚风险评估工具2.0（Cochrane RoB 2.0）与非随机研究偏倚风险评估工具(ROBINS-I)评估偏倚风险，并提取数据。以比值比(odds ratio, OR)及其95%置信区间(confidence interval, CI)作为主要统计指标；对于连续变量，则采用标准化均差(standardized mean difference, SMD)。采用I²统计量量化研究间的统计学异质性。

最终纳入21项研究，其中13项RCT与8项类实验研究，涉及来自9个国家的33096名受试者。出院计划可带来中等到大幅的改善：心理健康方面，抑郁症状（SMD=−0.64；95%CI：−1.27, −0.01）与焦虑症状（SMD=−1.29；95%CI：−2.22, −0.37）均显著缓解；自我护理与新生儿护理能力（OR=2.34；95%CI：1.20, 4.58）得到提升；母乳喂养自我效能（SMD=2.86；95%CI：1.63, 4.08）显著增强。整合出院前教育、出院后电话随访及信息化沟通平台的干预措施，往往展现出更大的效应量。

本系统评价与Meta分析显示，在产后早期于医院产科病房实施的结构化出院计划方案，可改善产妇心理健康状况、自我护理能力及母婴结局。本研究证据来自常规临床场景下开展的随机对照试验与务实类实验研究，表明病房或机构层面的出院干预措施，是优化产后过渡照护的有效且可推广的策略。

系统评价注册信息：https://www.crd.york.ac.uk/PROSPERO/view/CRD420251055810，注册日期为2025年5月20日。