Severe Maternal Morbidity and Postpartum Readmission Through 1 Year

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Public Health

Background:

• Severe maternal morbidity (SMM) during delivery is a critical concern.
• Understanding postpartum readmission risks is essential for maternal care.
• Current guidelines often focus on the immediate postpartum period.

Purpose of the Study:

• To estimate the risk of readmission up to one year postpartum for individuals with and without severe maternal morbidity (SMM) at delivery.
• To identify the most common diagnoses for postpartum readmission in these groups.

Main Methods:

• A cohort study using national health care claims data (IBM MarketScan, 2016-2018).
• Identification of delivery hospitalizations for individuals aged 15-49.
• SMM identified using diagnosis and procedure codes; follow-up for 365 days postpartum.
• Multivariable generalized linear models used to calculate adjusted relative risks (aRR) for readmission.

Main Results:

• The study included 459,872 deliveries; 1.1% had SMM.
• Individuals with SMM had a significantly higher cumulative incidence of readmission at all timepoints (42, 90, 180, and 365 days).
• The adjusted relative risk for readmission within 365 days was 1.44 (95% CI 1.28-1.61). Sepsis and hypertensive disorders were leading readmission diagnoses for those with SMM.

Conclusions:

• Severe maternal morbidity at delivery is linked to an elevated risk of postpartum readmission throughout the entire year.
• This highlights the need for extended monitoring and awareness of potential complications beyond the traditional 6-week postpartum period.
• Targeted interventions for conditions like sepsis and hypertensive disorders may reduce readmission rates.