Length of hospital stay, obstetric conditions at childbirth, and maternal readmission: A population-based cohort study

Objective: We assessed the association between obstetric conditions, length of hospital stay for childbirth, and maternal readmission. Study Design: A population-based cohort study was conducted on obstetric deliveries (N = 2,652,726) in Canada from 1989 to 1999. Women who were readmitted to the hospital because of obstetric causes within 60 days of initial discharge were identified. Results: Among the readmitted cases, women with cesarean deliveries were more likely to be readmitted to the hospital in the first week after discharge than women with vaginal deliveries (53% vs 41%). After an adjustment for maternal age by means of a Cox regression model, the risk of maternal readmission after cesarean delivery was significantly increased by 21%, 18%, and 10% for mothers with a length of hospital stay of ≤2, 3, and 4 days, respectively, compared with mothers with a length of hospital stay of 5 days. Postpartum hemorrhage, major puerperal infection, and some hypertensive disorders were associated with an elevated risk for maternal readmission and were also the major causes of readmission. Conclusion: Short length of hospital stay and several obstetric conditions appear to increase the risk of readmission in women with cesarean birth. (Am J Obstet Gynecol 2002;187:681-7.)