Readmissions among new mothers have been quietly rising. Now, researchers have identified comorbidities and other factors that contribute to maternal readmissions after childbirth.
A major goal of hospitals and health systems is to prevent 30-day readmissions among medical and surgical patients with conditions including COPD, heart failure, and hip and knee replacements.
But there's one cohort of patients about which little is known.
Readmissions among postpartum women have been quietly and sharply rising. They increased from 1.72% in 2004 to 2.16% in 2011—a 27% jump—a study by researchers from Brigham and Women's Hospital in Boston has found.
The study was designed to uncover trends in postpartum readmissions over time, to understand common indications and associated diagnoses that contribute to readmissions, and to determine maternal, delivery, and hospital characteristics associated with readmissions.
Researchers reviewed postpartum readmissions within the first 6 weeks of delivery in California, Florida, and New York. Patients more likely to be readmitted were those who were publicly insured, were black, had comorbid diseases such as hypertension and diabetes, and had a cesarean section.
Related: Hospitals Stingy with C-section Data
Common reasons for readmission were infection, hypertension, and psychiatric illness.
Patients were usually readmitted seven days post-discharge. On average, those with hypertension were admitted on postpartum day three, those with infections on postpartum day five, and those with psychiatric illness on postpartum day nine.
The strongest predictor for postpartum readmissions were maternal comorbidities of psychiatric disease, substance use, seizure disorder, hypertension, and tobacco use.
The researchers expressed hope that the data may lead to the development of new obstetrics quality metrics and to new strategies to decrease the rates of postpartum readmission.
The study was presented at the American College of Obstetricians and Gynecologists May 2016 annual meeting and received designation as a Donald F. Richardson prize paper at the event.