Length of hospital stay, obstetric conditions at childbirth, and maternal readmission: a population-based cohort study.
OBJECTIVE
We assessed the association between obstetric conditions, length of hospital stay for childbirth, and maternal readmission.


METHODS
A population-based cohort study was conducted on obstetric deliveries (N = 2,652,726) in Canada from 1989 to 1999. Women who were readmitted to the hospital because of obstetric causes within 60 days of initial discharge were identified.


RESULTS
Among the readmitted cases, women with cesarean deliveries were more likely to be readmitted to the hospital in the first week after discharge than women with vaginal deliveries (53% vs 41%). After an adjustment for maternal age by means of a Cox regression model, the risk of maternal readmission after cesarean delivery was significantly increased by 21%, 18%, and 10% for mothers with a length of hospital stay of <or=2, 3, and 4 days, respectively, compared with mothers with a length of hospital stay of 5 days. Postpartum hemorrhage, major puerperal infection, and some hypertensive disorders were associated with an elevated risk for maternal readmission and were also the major causes of readmission.


CONCLUSIONS
Short length of hospital stay and several obstetric conditions appear to increase the risk of readmission in women with cesarean birth.
Liu
Shiliang
S
Health Surveillance and Epidemiology Division, Centre for Healthy Human Development, Health Canada, and McLaughlin Center for Population Health Risk Assessment, University of Ottawa, ON, Canada. shiliang_liu@hc-sc.gc.ca
Heaman
Maureen
M
Kramer
Michael S
MS
Demissie
Kitaw
K
Wen
Shi Wu
SW
Marcoux
Sylvie
S
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D010359:Patient Readmission; D011247:Pregnancy; D011644:Puerperal Disorders / Q000209:etiology*