title: Hospital readmission after delivery: evidence for an increased incidence of nonurogenital infection in the immediate postpartum period.
abstract: 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.
authors.affiliation: Hospital Corporation of America, Nashville, TN, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Belfort
authors.forename: Steven L
authors.initials: SL
authors.lastname: Clark
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Kacie
authors.initials: K
authors.lastname: Kleja
authors.forename: Gary A
authors.initials: GA
authors.lastname: Dildy
authors.forename: Teelkien R
authors.initials: TR
authors.lastname: Van Veen
authors.forename: Efe
authors.initials: E
authors.lastname: Akhigbe
authors.forename: Donna R
authors.initials: DR
authors.lastname: Frye
authors.forename: Janet A
authors.initials: JA
authors.lastname: Meyers
authors.forename: Shalece
authors.initials: S
authors.lastname: Kofford
mesh_terms: 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*