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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Foundation Awardee

Poster Session 1

Category: Infectious Diseases

Poster Session 1

(384) Risk factors for postpartum readmissions due to surgical site infections after cesarean delivery.

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Tetsuya Kawakita, MD, MS (he/him/his)

    Associate Professor
    Eastern Virginia Medical School Department of Obstetrics and Gynecology, Macon & Joan Brock Virginia Health Sciences at Old Dominion University
    Norfolk, Virginia, United States

    • Coauthor(s)

  • Misa Hayasaka, MD

    Research scholar
    Macon & Joan Brock Virginia Health Sciences at Old Dominion University Eastern Virginia Medical School
    Norfolk, Virginia, United States

  • GS

    Grace Spencer, BS, MS

    Eastern Virginia Medical School at Old Dominion University
    EVMS OBGYN, Virginia Health Sciences at Old Dominion University, Virginia, United States

Objective:
To identify risk factors and timing of postpartum readmissions due to surgical site infections (SSI) after cesarean delivery.

Study Design:
This was a retrospective cohort study using the Healthcare Cost and Utilization Project (HCUP) National Readmissions Database from 2018 to 2022. We included all patients undergoing cesarean delivery. The primary outcome was readmission within 42 days postpartum for SSI, defined as wound infection, wound disruption, uterine infection, or sepsis. We used modified Poisson regression to estimate adjusted relative risks (aRR) with 95% confidence intervals (CI) for risk factors including demographics, comorbidities, cesarean indications, and neighborhood income (zip code quartiles). The timing of readmissions was plotted by days from discharge.

Results:

Among 2,563,282 patients, 16,650 (0.7%) were readmitted for SSI. Adjusted risks are presented in Table 1. The strongest risk factors were placenta accreta (aRR 2.17; 95% CI 1.81–2.60), pregestational diabetes (aRR 1.80; 95% CI 1.68–1.92), government insurance (aRR 1.58; 95% CI 1.52–1.63), arrest of active phase labor (aRR 1.52; 95% CI 1.44–1.60), obesity (aRR 1.47; 95% CI 1.42–1.52), and preterm delivery (aRR 1.44; 95% CI 1.38–1.50). Protective factors included higher income quartile (Q2 aRR 0.92, 95% CI 0.88–0.96; Q3 aRR 0.88, 95% CI 0.85–0.92; Q4 aRR 0.79, 95% CI 0.75–0.83, compared to Q1), prior cesarean (aRR 0.80; 95% CI 0.77–0.83), and placenta previa (aRR 0.86; 95% CI 0.76–0.97). Median time to readmission was 9 days post-discharge (Figure 1).

Conclusion:
SSI-related postpartum readmissions after cesarean delivery are infrequent but influenced by both clinical and social determinants of health. Most readmissions occur within the first two weeks, indicating a narrow window for intervention. Early outpatient follow-up, tailored discharge instructions, and targeted support for high-risk individuals—particularly those with medical comorbidities or lower socioeconomic status—may reduce the burden of readmissions and improve maternal recovery.