tetano
Editor, Senior Moderator
Am J Perinatol
. 2021 Dec 10.
doi: 10.1055/s-0041-1740061. Online ahead of print.
The Risk of Readmission after Early Postpartum Discharge during the COVID-19 Pandemic
Moti Gulersen[SUP] 1 [/SUP], Gregg Husk[SUP] 2 [/SUP], Erez Lenchner[SUP] 3 [/SUP], Matthew J Blitz[SUP] 4 [/SUP], Timothy J Rafael[SUP] 1 [/SUP], Burton Rochelson[SUP] 1 [/SUP], Shruti Chakravarthy[SUP] 3 5 [/SUP], Amos Grunebaum[SUP] 6 [/SUP], Frank A Chervenak[SUP] 6 [/SUP], Gary Fruhman[SUP] 3 5 [/SUP], Monique De Four Jones[SUP] 7 [/SUP], Benjamin Schwartz[SUP] 4 [/SUP], Michael Nimaroff[SUP] 1 [/SUP], Eran Bornstein[SUP] 6 [/SUP]
Affiliations
Abstract
Objective: 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.
Study design: 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.
Results: 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.
Conclusion: 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.
Key points: · 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..
. 2021 Dec 10.
doi: 10.1055/s-0041-1740061. Online ahead of print.
The Risk of Readmission after Early Postpartum Discharge during the COVID-19 Pandemic
Moti Gulersen[SUP] 1 [/SUP], Gregg Husk[SUP] 2 [/SUP], Erez Lenchner[SUP] 3 [/SUP], Matthew J Blitz[SUP] 4 [/SUP], Timothy J Rafael[SUP] 1 [/SUP], Burton Rochelson[SUP] 1 [/SUP], Shruti Chakravarthy[SUP] 3 5 [/SUP], Amos Grunebaum[SUP] 6 [/SUP], Frank A Chervenak[SUP] 6 [/SUP], Gary Fruhman[SUP] 3 5 [/SUP], Monique De Four Jones[SUP] 7 [/SUP], Benjamin Schwartz[SUP] 4 [/SUP], Michael Nimaroff[SUP] 1 [/SUP], Eran Bornstein[SUP] 6 [/SUP]
Affiliations
- PMID: 34891201
- DOI: 10.1055/s-0041-1740061
Abstract
Objective: 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.
Study design: 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.
Results: 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.
Conclusion: 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.
Key points: · 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..