Risk factors for re-hospitalization following cesarean delivery at term

IF 2.7 3区医学 Q2 OBSTETRICS & GYNECOLOGY International Journal of Gynecology & Obstetrics Pub Date : 2024-11-01 DOI:10.1002/ijgo.15997

Roy Bitan, Yotam Lior, Hila Shalev Ram, Roza Berkovitz-Shperling, Anat Lavie, Yariv Yogev, Shai Ram

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Abstract

Objective

To identify the key risk factors contributing to re-hospitalization after term cesarean delivery (CD).

Methods

This retrospective cohort study included women who underwent CD at term at a university-affiliated tertiary medical center (January 2021 to March 2023). The primary outcome was risk factors for re-hospitalization within 30 days post-discharge. Data on selected maternal demographic, pregnancy-related and delivery variables were extracted from electronic medical records. A multivariable logistic regression analysis was conducted to identify independent risk factors for re-hospitalization. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for various independent risk factors.

Results

A total of 2878 women were included in the study, of whom 76 required re-hospitalization (2.6%). The rates of high-risk pregnancies were more prevalent among those who were re-hospitalized (41 [62.1%] vs. 1148 [49.1%], P = 0.043). Furthermore, the rates of emergency CDs (42 [56%] vs. 1040 [37.8%], P = 0.001), prolonged surgery duration (17 [22.4%] vs. 292 [10.4%], P = 0.001) and hospitalization duration (14 (18.4%) vs. 273 (9.7%), P = 0.015) were significantly higher in the re-hospitalized group. Emergency CD (OR 1.90, 95% CI 1.06–3.42, P = 0.030) and prolonged surgery duration (OR 2.44, 95% CI 1.25–4.77, P = 0.016) remained significant risk factors of re-hospitalization in the multivariate analysis.

Conclusions

The need for emergency CD and prolonged surgery duration were found as independent risk factors for re-hospitalization after CD at term.

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临产剖宫产后再次住院的风险因素。

目的：确定导致足月剖宫产（CD）后再次住院的主要风险因素：确定导致足月剖宫产（CD）后再次住院的关键风险因素：这项回顾性队列研究纳入了在一所大学附属三级医疗中心接受足月剖宫产的产妇（2021 年 1 月至 2023 年 3 月）。主要结果是出院后 30 天内再次住院的风险因素。从电子病历中提取了部分产妇人口统计学、妊娠相关变量和分娩变量的数据。进行了多变量逻辑回归分析，以确定再次住院的独立风险因素。逻辑回归分析用于确定各种独立风险因素的几率比（ORs）和 95% 置信区间（CIs）：研究共纳入 2878 名妇女，其中 76 人需要再次住院（2.6%）。再次住院的妇女中高危妊娠的比例更高（41 [62.1%] 对 1148 [49.1%]，P = 0.043）。此外，再次住院组的急诊 CD 率（42 [56%] vs. 1040 [37.8%]，P = 0.001）、手术时间延长率（17 [22.4%] vs. 292 [10.4%]，P = 0.001）和住院时间（14 (18.4%) vs. 273 (9.7%)，P = 0.015）均显著高于再次住院组。在多变量分析中，急诊 CD（OR 1.90，95% CI 1.06-3.42，P = 0.030）和手术时间延长（OR 2.44，95% CI 1.25-4.77，P = 0.016）仍是再次住院的重要风险因素：结论：需要急诊剖腹产和手术时间过长是临产时剖腹产后再次住院的独立风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Gynecology & Obstetrics 医学-妇产科学

CiteScore

5.80

自引率

2.60%

发文量

493

审稿时长

3-6 weeks

期刊介绍： The International Journal of Gynecology & Obstetrics publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynecology and related subjects, with emphasis on matters of worldwide interest.