TITLE:
What Happens after the Puerperium? Analysis of “Late” Postpartum Readmissions in California
AUTHORS:
Brett C. Young, Erin Madden, Allison S. Bryant
KEYWORDS:
Diabetes in Pregnancy, Hypertension in Pregnancy, Hospital Readmission, Postpartum
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.3,
February
27,
2015
ABSTRACT:
Objective: Admissions to
acute care hospitals represent a significant portion of healthcare utilization.
Little is known regarding hospitalization in the first postpartum year beyond
the traditional 6 weeks of the puerperium. We sought to investigate whether
there are identifiable risk factors for hospital readmission during this time
period. Study Design: We conducted a retrospective population-based study using
all California birth records between 1999 and 2003. These records were linked
with hospital discharge data for all admissions to California hospitals in the
first 365 days after delivery. For women with a first birth during the study period,
we assessed the likelihood of readmission to an acute care hospital between 42
and 365 days post-delivery. Univariate and multivariable logistic regression
were used to determine risk factors for these “late postpartum” admissions.
Results: Of 951,570 maternal birth admissions during the time period, 15,727
(1.7%) women were admitted in the late postpartum period. Women with an early
postpartum readmission, antepartum admission, extremes of maternal age, black
race, diabetes, hypertension, early preterm delivery and cesarean delivery had
higher rates of late postpartum readmission. Of women with an antepartum
admission for gestational diabetes or pre-existing diabetes, 6.6% and 18.5% of
these women experienced a late postpartum admission for a diabetes-related
diagnosis. Conclusion: Hospital readmission rates in the first year postpartum,
remote from delivery, are significant. Women are at a higher risk of requiring
hospital admission in the first year postpartum with select demographics and
pregnancy-related diagnoses.