Hospital readmission after delivery: evidence for an increased incidence of nonurogenital infection in the immediate postpartum period.
OBJECTIVE
The purpose of this study was to analyze reasons for postpartum readmission.


METHODS
We conducted a database analysis of readmissions within 6 weeks after delivery during 2007, with extended (180 day) analysis for pneumonia, appendicitis, and cholecystitis. Linear regression analysis, survival curve fitting, and Gehan-Breslow statistic with Holm-Sidak all-pairwise analysis for multiple comparisons were used. Probability values of < .05 were considered significant.


RESULTS
Of 222,751 women delivered, 2655 women (1.2%) were readmitted within 6 weeks (0.83% vaginal delivery and 1.8% cesarean section delivery; P < .001). A high percentage of these readmittances occurred within the first 6 weeks: pneumonia (84%), appendicitis (43%), or cholecystitis (46%). Cumulative readmission rates were higher in the first 6 weeks after delivery than in the next 20 weeks (pneumonia curve gradient, 3.7 vs 0.11; appendicitis curve gradient, 1.1 vs 0.36; cholecystitis curve gradient, 6.6 vs 1.7).


CONCLUSIONS
The cause of postpartum readmission is primarily infectious in origin. A recent pregnancy appears to increase the risk of pneumonia, appendicitis, and cholecystitis.
Belfort
Michael A
MA
Hospital Corporation of America, Nashville, TN, USA.
Clark
Steven L
SL
Saade
George R
GR
Kleja
Kacie
K
Dildy
Gary A
GA
Van Veen
Teelkien R
TR
Akhigbe
Efe
E
Frye
Donna R
DR
Meyers
Janet A
JA
Kofford
Shalece
S
D001064:Appendicitis / Q000453:epidemiology*; D002585:Cesarean Section / Q000706:statistics & numerical data; D002764:Cholecystitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000453:epidemiology*; D049590:Postpartum Period / Q000502:physiology; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology*