The Risk of Readmission after Early Postpartum Discharge during the COVID-19 Pandemic
| Autor: | Moti Gulersen, Gregg Husk, Erez Lenchner, Matthew J. Blitz, Timothy J. Rafael, Burton Rochelson, Shruti Chakravarthy, Amos Grunebaum, Frank A. Chervenak, Gary Fruhman, Monique De Four Jones, Benjamin Schwartz, Michael Nimaroff, Eran Bornstein |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Postnatal Care Insurance Health Cesarean Section Medicaid SARS-CoV-2 Obstetrics and Gynecology COVID-19 Length of Stay Delivery Obstetric Patient Readmission Patient Discharge United States Cohort Studies Obesity Maternal Logistic Models Pregnancy Risk Factors Case-Control Studies Pediatrics Perinatology and Child Health Multivariate Analysis Humans Female Proportional Hazards Models Retrospective Studies |
| Zdroj: | American journal of perinatology. 39(4) |
| ISSN: | 1098-8785 |
| Popis: | To determine whether early postpartum discharge during the coronavirus disease 2019 (COVID-19) pandemic was associated with a change in the odds of maternal postpartum readmissions.This is a retrospective analysis of uncomplicated postpartum low-risk women in seven obstetrical units within a large New York health system. We compared the rate of postpartum readmissions within 6 weeks of delivery between two groups: low-risk women who had early postpartum discharge as part of our protocol during the COVID-19 pandemic (April 1-June 15, 2020) and similar low-risk patients with routine postpartum discharge from the same study centers 1 year prior. Statistical analysis included the use of Wilcoxon's rank-sum and chi-squared tests, Nelson-Aalen cumulative hazard curves, and multivariate logistic regression.Of the 8,206 patients included, 4,038 (49.2%) were patients who had early postpartum discharge during the COVID-19 pandemic and 4,168 (50.8%) were patients with routine postpartum discharge prior to the COVID-19 pandemic. The rates of postpartum readmissions after vaginal delivery (1.0 vs. 0.9%; adjusted odds ratio [OR]: 0.75, 95% confidence interval [CI]: 0.39-1.45) and cesarean delivery (1.5 vs. 1.9%; adjusted OR: 0.65, 95% CI: 0.29-1.45) were similar between the two groups. Demographic risk factors for postpartum readmission included Medicaid insurance and obesity.Early postpartum discharge during the COVID-19 pandemic was associated with no change in the odds of maternal postpartum readmissions after low-risk vaginal or cesarean deliveries. Early postpartum discharge for low-risk patients to shorten hospital length of stay should be considered in the face of public health crises.· Early postpartum discharge was not associated with an increase in odds of hospital readmissions after vaginal delivery.. · Early postpartum discharge was not associated with an increase in odds of hospital readmissions after cesarean delivery.. · Early postpartum discharge for low-risk patients should be considered during a public health crisis.. |
| Databáze: | OpenAIRE |
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