Delivery Complications and Postpartum Hospital Use in California
| Autor: | Chen Y. Wang, Joe Feinglass, Lynn M. Yee |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Health (social science) Adolescent Population California Article Cohort Studies symbols.namesake Pregnancy Maternity and Midwifery Medicine Humans Poisson regression education Hospital use Retrospective Studies education.field_of_study business.industry Obstetrics Public health Incidence (epidemiology) Postpartum Period Public Health Environmental and Occupational Health Obstetrics and Gynecology Emergency department Hospitals symbols Female business Medicaid Cohort study |
| Zdroj: | Womens Health Issues |
| ISSN: | 1878-4321 |
| Popis: | Introduction Research on maternal birth outcomes rarely includes postpartum complications with longitudinally linked patient data. We analyze characteristics associated with delivery complications and postpartum hospital use. Methods This population-based cohort study is based on administrative data from California. International Classification of Diseases, 10th Revision, codes were used to categorize the incidence of severe maternal morbidity and other route-specific delivery complications as well as preexisting and pregnancy-related conditions and principal diagnoses for postpartum hospital visits. Postpartum hospital use is a composite outcome defined as emergency department visit or hospital readmission within 90 days of birth admission discharge. Multivariable modified Poisson regression analyses were used to estimate the association of patient-level and hospital-level characteristics with the likelihood of postpartum hospital use. Results In 2017, 457,498 birth admissions occurred in California-licensed hospitals, of which 348,828 index births with linked data were analyzed. Among linked births, 34,825 (10.0%) had an inpatient admission (4,206 [1.2%]) or an emergency department visit (30,371 [9.2%]) within 90 days of birth admission discharge. Birth complications included a 1.7% severe maternal morbidity rate, 7.9% rate of vaginal birth complications, 10.0% rate of cesarean birth complications, and 2.9% frequency of long lengths of stay, all of which were significantly associated with postpartum hospital use. Other significant risk factors for postpartum hospital use were preexisting and pregnancy-related conditions, undergoing cesarean birth, being younger than 18 years old, being non-Hispanic Black, living in a high poverty ZIP code, and having Medicaid. Conclusion One in 10 birthing persons had a hospital visit within 90 days postpartum. Improving postpartum care is an urgent public health priority. |
| Databáze: | OpenAIRE |
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