(1192) Postpartum Readmissions and Associated Complications

Despite advances in obstetric care, the postpartum period remains a critical phase requiring improvement. This study aims to evaluate the incidence, timing, and predictors of postpartum hospital readmissions within 30 days of delivery.

Study Design:

This retrospective study evaluated postpartum readmission data across Texas HCA Healthcare hospitals using Clinical Classifications Software Refined (CCSR) codes, which aggregate International Classification of Diseases, 10th Revision (ICD-10) diagnosis codes. Statistical analyses were performed using SPSS v28.0.

Results:

Among 169,231 total deliveries, 56,012 were excluded due to missing data or other criteria, yielding a final sample of 113,219 cases. Among these, 13,334 patients were readmitted within 30 days postpartum. Average age was 29.5 years (±5.9). Delivery types were 52.1% vaginal and 47.9% cesarean, with average estimated blood loss of 122.1 mL (±271.7). Among 30-day readmissions, 62.3% were due to pregnancy-related conditions (PRC), 8.3% to genitourinary disorders, and 9.1% to ill-defined symptoms. Within PRC, the most common diagnoses were other specified puerperal complications (14.1%), severe/unspecified pre-eclampsia (9.8%), and postpartum hemorrhage (3.1%). Average time to readmission was 9 days (±7.9). Binary logistic regression identified significant predictors of readmission (all p < .001): Black race (OR=1.3672, 95% CI: 1.2741–1.4670,); obesity (OR=1.2798), psychiatric diagnosis (OR=1.3351), diabetes (OR=1.1295), and hypertensive disorders (OR=1.7622).

Conclusion:

Postpartum complications requiring readmission can disrupt early mother-infant bonding and contribute to increased maternal morbidity. This study highlights racial disparities and influence of comorbid conditions in high-risk populations, showing that upstream prenatal intervention can directly affect downstream outcomes. Findings also support ACOG guidance on early postpartum follow-up within three weeks, a critical time to reduce maternal readmission, improving postpartum outcomes.