Risk Factors for Rehospitalization in the Puerperium [18L]

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Abstract

INTRODUCTION:

Little is known about clinical risk factors for postpartum readmission in the United States. As such, the objective of this study was to clarify the indications and risk factors for postpartum rehospitalization.

METHODS:

Retrospective case-control study. Cases were women readmitted within 30 days of delivery at a single institution from January 1–December 31, 2013 (n=104). The control group consisted of women who had the next delivery but were not readmitted (N=104). Wilcoxon Rank-Sum and Fisher exact tests were used to compare nonparametric continuous variables and proportions respectively. Logistic regression using forward selection was utilized to identify independent risk factors for readmission.

RESULTS:

The incidence of readmission was 1.4% (104/7568 deliveries). The most common indications for readmission were infection (41.4%) and hypertension (HTN) (37.5%). Although there was no difference among cases and controls in the percentage of patients who underwent induction of labor (IOL) (38.6% vs 30.7%, P=.3), the length of induction was longer for the readmitted patients (0.85 days vs 0.52 days, P=.01). Cases were also more likely to have HTN during their pregnancy or immediately postpartum (28.9% vs 6.7%, P=<.01). In the multivariate analysis, HTN was independently associated with readmission (OR 4.9, 95% CI 2.0–12.1, P=<.01). For those who underwent IOL, length of induction was also associated with readmission (OR 2.9, 95% CI 1.1–7.9, P=.04).

CONCLUSION:

HTN is an independent risk factor for postpartum readmission. For patients undergoing IOL, longer length of induction was associated with an increased risk of rehospitalization.

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