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Risk factors for postpartum readmission among women after having a stillbirth

      BACKGROUND

      Compared to women with a live birth, women with a stillbirth are more likely to have maternal complications during pregnancy and at birth, but risk factors related to their postpartum health are uncertain.

      OBJECTIVE

      This study aimed to identify patient-level risk factors for postpartum hospital readmission among women after having a stillbirth.

      STUDY DESIGN

      This was a population-based cohort study of 29,654 women with a stillbirth in California from 1997 to 2011. Using logistic regression models, we examined the association of maternal patient-level factors with postpartum readmission among women after a stillbirth within 6 weeks of hospital discharge and between 6 weeks and 9 months after delivery.

      RESULTS

      Within 6 weeks after a stillbirth, 642 women (2.2%) had a postpartum readmission. Risk factors for postpartum readmission after a stillbirth were severe maternal morbidity excluding transfusion (adjusted odds ratio, 3.02; 95% confidence interval, 2.28–4.00), transfusion at delivery but no other indication of severe maternal morbidity (adjusted odds ratio, 1.95; 95% confidence interval, 1.35–2.81), gestational hypertension or preeclampsia (adjusted odds ratio, 1.93; 95% confidence interval, 1.54–2.42), prepregnancy hypertension (adjusted odds ratio, 1.80; 95% confidence interval, 1.36–2.37), diabetes mellitus (adjusted odds ratio, 1.78; 95% confidence interval, 1.33–2.37), antenatal hospitalization (adjusted odds ratio, 1.78; 95% confidence interval, 1.43–2.21), cesarean delivery (adjusted odds ratio, 1.73; 95% confidence interval, 1.43–2.21), long length of stay in the hospital after delivery (>2 days for vaginal delivery and >4 days for cesarean delivery) (adjusted odds ratio, 1.59; 95% confidence interval, 1.33–1.89), non-Hispanic black race and ethnicity (adjusted odds ratio, 1.38; 95% confidence interval, 1.08–1.76), and having less than a high school education (adjusted odds ratio, 1.35; 95% confidence interval, 1.02–1.80). From 6 weeks to 9 months, 1169 women (3.90%) had a postpartum readmission; significantly associated risk factors were largely similar to those for earlier readmission.

      CONCLUSION

      Women with comorbidities, with birth-related complications, of non-Hispanic black race and ethnicity, or with less education had increased odds of postpartum readmission after having a stillbirth, highlighting the importance of continued care for these women after discharge from the hospital.

      Key words

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