Postnatal ER visits within 30 days-Pattern, risk factors and implications for care

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Health Services Research

Background:

• Postpartum care is crucial for maternal health.
• Understanding emergency room (ER) visit patterns post-childbirth is essential for improving maternal outcomes.
• Current follow-up protocols may not adequately address immediate postpartum needs.

Purpose of the Study:

• To analyze care-seeking patterns for emergency room visits within 30 days postpartum.
• To identify risk factors associated with emergency room contact after childbirth.
• To inform clinical implications for enhanced postnatal follow-up strategies.

Main Methods:

• Longitudinal study design utilizing anonymized data from Stockholm County, Sweden (2013 births).
• Descriptive and inferential statistical analyses, including Cox regression.
• Analysis of healthcare encounters, diagnoses, and timing relative to childbirth and discharge over a 30-day period.

Main Results:

• 12.2% of women (3,533/28,963) visited the emergency room at least once within 30 days postpartum.
• Emergency room visits peaked around day 6 post-discharge, often occurring when routine check-ups were absent.
• Caesarean delivery, assisted birth, and sphincter injuries were significant risk factors for emergency room visits.

Conclusions:

• Emergency room visits are concentrated in the early postpartum period, highlighting a gap in routine check-ups.
• Women experiencing childbirth complications require improved early support and follow-up post-discharge.
• Enhanced maternity care and midwifery interventions can prevent avoidable emergency room visits and improve postpartum recovery.