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Cited by 191Maternal and Perinatal Health InterventionsMaternal and fetal healthcareAnesthesia and Pain Management

Risk of Maternal Postpartum Readmission Associated With Mode of Delivery

Liu, Shiliang, Heaman, Maureen, Joseph, K S., Liston, Robert M., Huang, Ling, Sauve, Reg, Kramer, Michael S.·2005·Obstetrics & Gynecology
DOI 10.1097/01.aog.0000154153.31193.2c
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Abstract

OBJECTIVE: To determine whether cesarean and operative vaginal deliveries are associated with an increased risk of maternal rehospitalization compared with spontaneous vaginal delivery. METHODS: A population-based cohort study was conducted by using the Canadian Institute for Health Information's Discharge Abstract Database between 1997/1998 and 2000/2001, which included 900,108 women aged 15-44 years with singleton live births (after excluding several selected obstetric conditions). RESULTS: A total of 16,404 women (1.8%) were rehospitalized within 60 days after initial discharge. Compared with spontaneous vaginal delivery (rate 1.5%), cesarean delivery was associated with a significantly increased risk of postpartum readmission (rate 2.7%, odds ratio [OR] 1.9, 95% confidence interval [CI] 1.8-1.9); ie, there was 1 excess postpartum readmission per 75 cesarean deliveries. Diagnoses associated with significantly increased risks of readmission after cesarean delivery (compared with spontaneous vaginal delivery) included pelvic injury/wounds (rate 0.86% versus 0.06%, OR 13.4, 95% CI 12.0-15.0), obstetric complications (rate 0.23% versus 0.08%, OR 3.0, 95% CI 2.6-3.5), venous disorders and thromboembolism (rate 0.07% versus 0.03%, OR 2.7, 95% CI 2.1-3.4), and major puerperal infection (rate 0.45% versus 0.27%, OR 1.8, 95% CI 1.6-1.9). Women delivered by forceps or vacuum were also at an increased risk of readmission (rates 2.2% and 1.8% versus 1.5%; OR forceps: 1.4, 95% CI 1.3-1.5; OR vacuum: 1.2, 95% CI 1.2-1.3, respectively). Higher readmission rates after operative vaginal delivery were due to pelvic injury/wounds, genitourinary conditions, obstetric complications, postpartum hemorrhage, and major puerperal infection. CONCLUSION: Compared with spontaneous vaginal delivery, cesarean delivery, and operative vaginal delivery increase the risk of maternal postpartum readmission. LEVEL OF EVIDENCE: II-2.

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Authors
Liu, S., Heaman, M., Joseph, K. S., Liston, R. M., Huang, L., Sauve, R., & Kramer, M. S.
Affiliations
  • Public Health Agency of Canada (CA)
  • Canadian Institutes of Health Research (CA)
  • Dalhousie University (CA)
  • University of British Columbia (CA)
  • University of Calgary (CA)
Corresponding author
  • Liu, Shiliang
  • Huang, Ling
ORCID
Venue
Obstetrics & Gynecology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-04
Volume
105
Issue
4
Pages
836-842
ISSN
0029-7844 (ISSN-L)
DOI
10.1097/01.aog.0000154153.31193.2c
OpenAlex
W2325235714
Cited by
191
References
26
Citations by year
2026: 2 · 2025: 4 · 2024: 11 · 2023: 12 · 2022: 7 · 2021: 10 · 2020: 8 · 2019: 13 · 2018: 4 · 2017: 13 · 2016: 8 · 2015: 9 · 2014: 10 · 2013: 6 · 2012: 8
FWCI
11.68
Type
journal article
Language
en
Open access
closed
Locations
  • Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
Keywords
cesarean section, instrumental delivery, mode of delivery, normal delivery, postpartum hemorrhage, postpartum infection, pelvic trauma, pregnancy complications, venous thromboembolism, forceps delivery, vacuum extraction, hospital readmission risk factors, singleton live births
MeSH terms
Adolescent, Adult, Canada, Cesarean Section, Female, Humans, Patient Discharge, Patient Readmission, Pregnancy, Puerperal Disorders, Risk Factors, Databases, Factual, Outcome Assessment, Health Care, Delivery, Obstetric

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