Does transitional care improve neonatal and maternal health outcomes? A systematic review

Abstract

Current evidence has shown that transitional care benefits the health outcomes of moderately compromised infants and mothers in terms of de-medicalisation of care, improving mother and infant attachments, parenting skills for dependant infants and the potential for shorter length of hospitalisation. Transitional care units exist in a variety of forms in neonatal services, ranging from nurse-led to midwife-led units. This review establishes whether transitional care units improve maternal and neonatal health outcomes. Objective: To review and synthesise published research on ‘Does transitional care improve neonatal and maternal health outcomes?’ Methods: Systematic reviews of published literature from nine electronic databases were undertaken and a total of ten studies were reviewed that met the reviews inclusion criteria. Findings: Five studies were rated as moderate strength, four studies were rated as very high quality and one study was rated as poor quality. Three overarching primary outcomes were identified. Within each outcome, a series of seven secondary outcome measures were reported. These included very positive benefits on one end of the scale and no benefits at the other end. The outcome measures report inconsistently across studies of the values of transitional care units for infants, ‘shorter length of stay’, ‘transitional model of care’ and the ‘reduced risks of infection’. Family centred care, mother as main carer, and increased bonding and attachments featured strongly across studies and thus supported the benefits of transitional care units in improving neonatal and maternal health outcomes. Conclusion: This review highlighted the values of transitional care in increasing the ‘mother–infant’ model of care. More studies are required for the evidence base for strategies to reduce the length of hospitalisation for moderately vulnerable infants. It was discovered that there are substantial variables in transitional care unit practices in the UK, as well as a need for well-conducted studies.