Risk Factors for Prolonged Postpartum Length of Stay Following Cesarean Delivery

Yair J. Blumenfeld; Yasser Y. El-Sayed; Deirdre J. Lyell; Lorene M. Nelson; Alexander J. Butwick

doi:10.1055/s-0034-1543953

American Journal of Perinatology, Table of Contents

Am J Perinatol 2015; 32(09): 825-832
DOI: 10.1055/s-0034-1543953

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Risk Factors for Prolonged Postpartum Length of Stay Following Cesarean Delivery

Authors

Yair J. Blumenfeld

¹Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
Yasser Y. El-Sayed

¹Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
Deirdre J. Lyell

¹Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
Lorene M. Nelson

²Department of Health Research and Policy, Stanford University, Stanford, California
Alexander J. Butwick

³Department of Anesthesia, Stanford University School of Medicine, Stanford, California

Abstract

Objective This study aims to identify risk factors for prolonged postpartum length of stays (LOS) after cesarean delivery (CD).

Study Design Patients undergoing CD were sourced from a multicenter registry of 19 academic centers between 1999 and 2002 (n = 57,067). Prolonged postpartum LOS was defined as a hospitalization duration ≥ 90th centile. Maternal, antepartum, perioperative, and neonatal variables were compared between women with and without prolonged postpartum LOS.

Results The 90th centile for postpartum LOS was 4 days, with 14,954 women experiencing prolonged postpartum LOS. Women with perioperative complications had the highest independent risk for a prolonged postpartum LOS: ileus (adjusted odds ratio [aOR] = 12.28; 95% confidence interval CI = 8.98–16.8); endometritis (aOR = 10.45; 95% CI = 9.51–11.5), and wound complications (aOR = 5.49; 95% CI = 4.54–6.63). Several antepartum, perioperative, and neonatal variables were associated with a prolonged postpartum LOS.

Conclusion Perioperative complications had the highest risk for prolonged LOS after CD. Strategies to reduce perioperative complications are needed to decrease the health care burden of prolonged post-CD LOS.

Keywords

cesarean - postpartum length of stay - prolonged

Full Text

References

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