(622) Risk factors associated with readmission after cesarean delivery in the setting of intra-amniotic infection

National safety and quality efforts aim to reduce the rates of postpartum readmissions for delivering and postpartum individuals. We sought to further clarify differences in risk factors for readmission as well as identify possible modifiable risk factors to further aid in reaching this goal within our population of interest.


Study Design:
This was an IRB approved, retrospective cohort study of patients undergoing cesarean with intraamniotic infection (IAI) in a single healthcare system from 4/1/2013 to 11/2/2019. Patients missing data regarding delivery, antibiotic use, or IAI diagnosis were excluded. The primary outcomes of interest were factors associated with readmission among this population. We used bivariate tests and multivariate logistic regression for comparisons.

Results:

Of the 985 patients who met inclusion criteria, 40 (4.1%) were readmitted. Differences in patient age, race, diabetes status, BMI, penicillin allergy status, and length of membrane rupture were observed (Table 1). Readmission for patients who delivered via cesarean section in the setting of IAI was significantly associated with prolonged rupture of membranes (aOR 2.4; p< 0.05) and penicillin allergy (aOR 4.36; p< 0.05). Azithromycin administration was protective (aOR 0.30; p< 0.05) (Table 2).


Conclusion:

Differences by race/ethnicity as well as BMI and pre-existing conditions exist for women delivering via CS in the setting of IAI. Prolonged rupture of membrane and penicillin allergy were significantly associated with readmission. These findings further support the evidence for predelivery optimization with consideration of allergy testing antenatally.