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Published on: January 27, 2010
Risk Factors for Prolonged Postpartum Length of Stay Following Cesarean Delivery
Yair J Blumenfeld1, Yasser Y El-Sayed1, Deirdre J Lyell1
1Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
Objective:
This study aims to identify risk factors for prolonged postpartum length of stays (LOS) after cesarean delivery (CD).
Study Design:
Patients undergoing CD were sourced from a multicenter registry of 19 academic centers between 1999 and 2002 (n = 57,067). Prolonged postpartum LOS was defined as a hospitalization duration ≥ 90th centile. Maternal, antepartum, perioperative, and neonatal variables were compared between women with and without prolonged postpartum LOS.
Results:
The 90th centile for postpartum LOS was 4 days, with 14,954 women experiencing prolonged postpartum LOS. Women with perioperative complications had the highest independent risk for a prolonged postpartum LOS: ileus (adjusted odds ratio [aOR] = 12.28; 95% confidence interval CI = 8.98-16.8); endometritis (aOR = 10.45; 95% CI = 9.51-11.5), and wound complications (aOR = 5.49; 95% CI = 4.54-6.63). Several antepartum, perioperative, and neonatal variables were associated with a prolonged postpartum LOS.
Conclusion:
Perioperative complications had the highest risk for prolonged LOS after CD. Strategies to reduce perioperative complications are needed to decrease the health care burden of prolonged post-CD LOS.
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