 |
|
Association Between Method of Delivery and Maternal Rehospitalization
Mona Lydon-Rochelle, MPH, PhD, CNM;
Victoria L. Holt, MPH, PhD;
Diane P. Martin, MA, PhD;
Thomas R. Easterling, MD
JAMA. 2000;283:2411-2416.
Context Despite nearly 4 million deliveries in the United States each year, minimal information exists on unintended health consequences following childbirth, particularly in relation to delivery method.
Objective To assess the risk for maternal rehospitalization associated with cesarean or assisted vaginal delivery compared with spontaneous vaginal delivery.
Design Retrospective cohort study of data from the Washington State Birth Events Record Database for 1987 through November 1, 1996.
Setting and Participants All primiparous women without selected chronic medical conditions who delivered live singleton infants in nonfederal short-stay hospitals in Washington State (N=256,795).
Main Outcome Measures Relative risks (RRs) of rehospitalization within 60 days of cesarean or assisted vaginal vs spontaneous vaginal deliveries.
Results A total of 3149 women (1.2%) were rehospitalized within 60 days of delivery. In logistic regression analyses adjusting for maternal age, rehospitalization was found to be more likely among women with cesarean delivery (RR, 1.8; 95% confidence interval [CI], 1.6-1.9) or assisted vaginal delivery (RR, 1.3; 95% CI, 1.2-1.4) than among women with spontaneous vaginal delivery. Cesarean delivery was associated with significantly increased risks of rehospitalization for uterine infection, obstetrical surgical wound complications, and cardiopulmonary and thromboembolic conditions. Among women with assisted vaginal delivery, significant increased risks were seen for rehospitalization with postpartum hemorrhage, obstetrical surgical wound complications, and pelvic injury.
Conclusions Women with cesarean and assisted vaginal deliveries were at increased risk for rehospitalization, particularly with infectious morbidities. Effective strategies for preventing and controlling peripartum infection should be an obstetrical priority.
Author Affiliations: Department of Health Services, School of Public Health and Community Medicine (Drs Lydon-Rochelle and Martin); Department of Family and Child Nursing, School of Nursing (Dr Lydon-Rochelle); Department of Epidemiology, School of Public Health and Community Medicine (Dr Holt); and Department of Obstetrics and Gynecology, School of Medicine (Dr Easterling), University of Washington, Seattle.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED LETTER
Cesarean Delivery and Risk of Herpes Simplex Virus Infection
and
JAMA. ;289():2208-2208.
FULL TEXT
RELATED ARTICLE
May 10, 2000
JAMA. ;283():2461-2462.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Risks of Complications by Attending Physicians After Performing Nighttime Procedures
Rothschild et al.
JAMA 2009;302:1565-1572.
ABSTRACT
| FULL TEXT
Incidental Findings During Routine Antepartum Obstetrical Sonography
Jeanty et al.
Journal of Diagnostic Medical Sonography 2008;24:344-360.
ABSTRACT
Cesarean Delivery as a Barrier for Breastfeeding Initiation: The Puerto Rican Experience
Perez-Rios et al.
J Hum Lact 2008;24:293-302.
ABSTRACT
Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term
Liu et al.
CMAJ 2007;176:455-460.
ABSTRACT
| FULL TEXT
Not safer and not cheaper?
Klein
CMAJ 2006;175:1243-1246.
FULL TEXT
Geographic Variation In The Appropriate Use Of Cesarean Delivery
Baicker et al.
Health Aff (Millwood) 2006;25:w355-w367.
ABSTRACT
| FULL TEXT
Postpartum Health of Employed Mothers 5 Weeks After Childbirth
McGovern et al.
Ann Fam Med 2006;4:159-167.
ABSTRACT
| FULL TEXT
Relative Risk of Postpartum Complications in the Ohio Medicaid Population: Vaginal Versus Cesarean Delivery
Koroukian
Med Care Res Rev 2004;61:203-224.
ABSTRACT
Cesarean Delivery and Risk of Herpes Simplex Virus Infection
Cohan
JAMA 2003;289:2208-2208.
FULL TEXT
Magnitude of Maternal Morbidity During Labor and Delivery: United States, 1993-1997
Danel et al.
AJPH 2003;93:631-634.
ABSTRACT
| FULL TEXT
Elective Primary Cesarean Delivery
Minkoff and Chervenak
NEJM 2003;348:946-950.
FULL TEXT
Mode of Delivery and Risk of Postpartum Rehospitalization
Webb and Robbins
JAMA 2003;289:46-47.
FULL TEXT
Uterine Rupture among Women with a Prior Cesarean Delivery
Heffner et al.
NEJM 2002;346:134-137.
FULL TEXT
|
