DOI: 10.14288/1.0432281
title: Smart Discharges for Mom & Baby 2.0: A cohort study to develop prognostic algorithms for post-discharge readmission and mortality among mother-infant dyads

description: &lt;br /&gt;&lt;strong&gt;Dataset Description:&lt;/strong&gt; This dataset contains materials from the Smart Discharges for Mom & Baby parent study within the &lt;a href = "https://bcchr.ca/smart-discharges"&gt;Smart Discharges&lt;/a&gt; program of research. Materials include the parent study ethics protocol and associated documents. See the Metadata section below for links to related publications and datasets.&lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Background:&lt;/strong&gt; In low-income country settings, the first six weeks after birth remain a critical period of vulnerability for both mother and newborn. Despite recommendations for routine post-discharge follow-up, few mothers and newborns receive guideline recommended care during this period. Prediction modelling of post-delivery outcomes has the potential to improve outcomes for both mother and newborn by identifying high-risk dyads, improving risk communication, and facilitating a patient-centered approach to postnatal care. &lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a mixed-methods study to explore and map the current postnatal discharge processes in Uganda.We will conduct an observational cohort study (Phase I) to develop and internally validate our risk score and aim to recruit 7,000 mother and newborn dyads from Jinja Regional Referral Hospital and Mbarara Regional Referral Hospital. We will also engage with patients, families, and health workers through patient journey mapping and focus group discussions (Phases II-IV) to identify barriers and facilitators to inform the development of an evidence- and risk-based bundle of interventions to improve postnatal care (PNC) for dyads. &lt;br /&gt; &lt;br /&gt;The primary outcome is maternal and/or neonatal death or need for re-admission within six weeks of birth. &lt;br /&gt; &lt;br /&gt;Secondary outcomes include:&lt;br /&gt; 1. Post-natal care visits during the 6-week post-discharge period &lt;br /&gt; 2. Post-discharge health seeking practices for mothers/newborns during the 6-week post-discharge period&lt;br /&gt; 3. Causes of readmission/mortality among those who experience such outcomes, based on verbal autopsies and admission symptom/diagnosis questionnaires.&lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Data Collection Methods:&lt;/strong&gt; All data will be collected at the point of care using encrypted study tablets. These data will be uploaded to a Research Electronic Data Capture (REDCap) database hosted at the BC Children’s Hospital Research Institute (Vancouver, Canada). At admission, trained study nurses will systematically collect data on clinical, social and demographic variables. Following discharge, field officers will contact mothers at 6-weeks post-discharge, to determine vital status, post-discharge health-seeking, and readmission details. Verbal autopsies were conducted for participants who had died following discharge.&lt;br /&gt; &lt;br /&gt; Direct observation and interviews will be conducted on a sub-set of participants to collect process outcomes and barriers and facilitators to the patient's journey. FGDs will be digitally recorded, transcribed verbatim in the language spoken during the recording and analyzed for emerging themes. &lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Ethics Declaration:&lt;/strong&gt; Ethics approvals have been obtained from the Makerere University School of Public Health (MakSPH) Institutional Review Board (SPH-2021-177), the Uganda National Council of Science and Technology (UNCST) in Uganda (HS2174ES) and the University of British Columbia in Canada (H21-03709). This study has been registered at clinicaltrials.gov (NCT05730387).&lt;br /&gt; &lt;br /&gt;&lt;strong&gt;Associated datasets:&lt;/strong&gt; &lt;br /&gt; Pending publication