Hospital readmission after delivery: evidence for an increased incidence of nonurogenital infection in the immediate postpartum period

Am J Obstet Gynecol. 2010 Jan;202(1):35.e1-7. doi: 10.1016/j.ajog.2009.08.029. Epub 2009 Nov 4.


Objective: The purpose of this study was to analyze reasons for postpartum readmission.

Study design: We conducted a database analysis of readmissions within 6 weeks after delivery during 2007, with extended (180 day) analysis for pneumonia, appendicitis, and cholecystitis. Linear regression analysis, survival curve fitting, and Gehan-Breslow statistic with Holm-Sidak all-pairwise analysis for multiple comparisons were used. Probability values of < .05 were considered significant.

Results: Of 222,751 women delivered, 2655 women (1.2%) were readmitted within 6 weeks (0.83% vaginal delivery and 1.8% cesarean section delivery; P < .001). A high percentage of these readmittances occurred within the first 6 weeks: pneumonia (84%), appendicitis (43%), or cholecystitis (46%). Cumulative readmission rates were higher in the first 6 weeks after delivery than in the next 20 weeks (pneumonia curve gradient, 3.7 vs 0.11; appendicitis curve gradient, 1.1 vs 0.36; cholecystitis curve gradient, 6.6 vs 1.7).

Conclusion: The cause of postpartum readmission is primarily infectious in origin. A recent pregnancy appears to increase the risk of pneumonia, appendicitis, and cholecystitis.

MeSH terms

  • Appendicitis / epidemiology*
  • Cesarean Section / statistics & numerical data
  • Cholecystitis / epidemiology*
  • Female
  • Humans
  • Incidence
  • Patient Readmission / statistics & numerical data*
  • Pneumonia / epidemiology*
  • Postpartum Period / physiology
  • Pregnancy
  • Puerperal Disorders / epidemiology*