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Poster Session 2

Category: Medical/Surgical/Diseases/Complications

Poster Session 2

(496) National trends in postpartum readmission for de novo endometritis, 2010-2021

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Grace K. Noonan, MD (she/her/hers)

Obstetrics and Gynecology Resident
Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego
San Diego, California, United States

Coauthor(s)

Rachel L. Wiley, MD, MPH (she/her/hers)

Maternal Fetal Medicine Fellow
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
AF

Alexander M. Friedman, MD, MPH

Professor of Obstetrics and Gynecology
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center
New York, New York, United States
Cynthia Gyamfi-Bannerman, MD, MS (she/her/hers)

Professor and Chair
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
TW

Timothy Wen, MD, MPH

Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States

Objective:
Over the past decade, changing antibiotic practices have aimed to reduce delivery-related infections; however, the impact on de novo postpartum endometritis readmissions is unknown. Our aim is to evaluate national trends and risk factors associated with 60-day postpartum readmission for de novo endometritis during this time period.

Study Design:
The 2010-2021 Nationwide Readmissions Database was utilized for this cross-sectional analysis. Delivery hospitalizations (excluding those with delivery-related infection, shock/sepsis, or hysterectomy) and de novo readmissions within 60 days complicated by endometritis were ascertained. Temporal trends for 60-day postpartum endometritis readmissions were evaluated utilizing joinpoint regression to estimate average annual percent change (AAPC) and 95% confidence intervals (CI). Unadjusted and adjusted logistic regression models were fit to assess the relationship between clinical, demographic, and hospital factors with odds ratios (OR) to measure associations.

Results:
Among 35.9 million births included, 69,712 (0.2%) were complicated by a 60-day readmission complicated by endometritis. Rates of readmissions decreased from 23.8 to 14.5 per 10,000 birth hospitalizations (APC −5.3%, 95% CI -8.1%, -2.9%), with the largest decline in 2014–2017 (APC −12.9%; 95% CI –16.7%, -8.1%) (Figure). Readmission was more likely in younger patients and those with diabetes, obesity, multiple gestations, smoking, or immunosuppression (Table). Operative delivery (aOR 1.28; 95% CI: 1.20-1.36), cesarean delivery (aOR 1.94; 95% CI: 1.88-2.00), postpartum hemorrhage (aOR 2.08; 95% CI: 1.97-2.19) and dilation and curettage (aOR 1.97; 95% CI: 1.76-2.19) were independently associated with readmission.

Conclusion:
National data show declining endometritis readmissions, suggesting benefits from recent practice changes. Yet, identifiable risk factors remain. Our findings support proactive postpartum care models, including education for symptom recognition, timely follow up and improved outpatient monitoring.