Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Women's Health Reviews
  4. Volume 21, Issue 3
  5. Article
Volume 21, Issue 3
  • ISSN: 1573-4048
  • E-ISSN: 1875-6581

Abstract

Background

Postpartum readmission is one of the metrics for assessing the quality of health services. There is inconsistent evidence about postpartum readmission and complications by mode of delivery.

Objective

We applied a meta-analysis to investigate whether the mode of delivery is associated with postpartum readmission or complications.

Methods

We systematically searched main English databases for studies published up to June 2022. The Newcastle–Ottawa scale (NOS) was used to assess the quality of observational studies. The heterogeneity of included studies was determined using the I2 statistic and Begg’s and Egger’s tests for publication bias, respectively. Results of the random-effects meta-analysis were presented using odds ratio (OR) estimates with 95% confidence intervals (CI). The Stata software version 16 was used for data analysis.

Results

In total, 18 studies with 514,577 subjects were suitable for reviewing maternal postpartum readmission by mode of delivery. Our findings show that cesarean delivery is a risk factor for increasing postpartum readmission than the vaginal delivery method (overall OR =1.42, CI 95% 1.22, 1.63, I2= 99.7%, = 0.001). This chance was increased in primary cesarean (OR=2). Postpartum hemorrhage and breast infection did not have risk factors for postpartum readmission. While cardiopulmonary condition, deep vein thrombosis (DVT), genitourinary condition, and wound complication were risk factors among causes.

Conclusion

Cesarean delivery is one of the most important risk factors for postpartum readmission, especially both childbirth-related/non-related complications causes. Therefore, it is necessary to revise the schedule of postpartum visits based on the type of delivery.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cwhr/10.2174/0115734048259364230926093806
2024-01-29
2024-12-23

  • From This Site

    /content/journals/cwhr/10.2174/0115734048259364230926093806
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. WangS. ZhuX. Predictive modeling of hospital readmission: Challenges and solutions.IEEE/ACM Trans. Comput. Biol. Bioinformatics202119529752995
     [Google Scholar]
  2. ArtetxeA. BeristainA. GrañaM. Predictive models for hospital readmission risk: A systematic review of methods.Comput. Methods Programs Biomed.2018164496410.1016/j.cmpb.2018.06.00630195431
     [Google Scholar]
  3. KripalaniS. TheobaldC.N. AnctilB. VasilevskisE.E. Reducing hospital readmission rates: Current strategies and future directions.Annu. Rev. Med.201465147148510.1146/annurev‑med‑022613‑09041524160939
     [Google Scholar]
  4. NarmanliM. ÖzgüçH. Çevi̇kkalpE. SerbestN. Analysis of unplanned revisits and readmissions: Results of the General Surgery clinic in a private hospital.Eur. Respir. J.202281657310.18621/eurj.853033
     [Google Scholar]
  5. McKechnieD. PryorJ. McKechnieR. FisherM.J. Predictors of readmission to acute care from inpatient rehabilitation: An integrative review.PM R201911121335134510.1002/pmrj.1217931041836
     [Google Scholar]
  6. ReevesR.A. SchairerW.W. JevsevarD.S. The national burden of periprosthetic hip fractures in the US: Costs and risk factors for hospital readmission.Hip Int.201929555055710.1177/112070001880393330270669
     [Google Scholar]
  7. JencksS.F. WilliamsM.V. ColemanE.A. Rehospitalizations among patients in the Medicare fee-for-service program.N. Engl. J. Med.2009360141418142810.1056/NEJMsa080356319339721
     [Google Scholar]
  8. MatasJ.L. MitchellL.E. SharmaS.V. LouisJ.M. SalemiJ.L. Severe maternal morbidity at delivery and postpartum readmission in the United States.Paediatr. Perinat. Epidemiol.202135662763410.1111/ppe.1276233738822
     [Google Scholar]
  9. DiTostoJ.D. LiuC. Wall-WielerE. GibbsR.S. GirsenA.I. El-SayedY.Y. ButwickA.J. CarmichaelS.L. Risk factors for postpartum readmission among women after having a stillbirth.Am. J. Obstet. Gynecol. MFM20213410034510.1016/j.ajogmf.2021.10034533705999
     [Google Scholar]
  10. ClappM.A. LittleS.E. ZhengJ. RobinsonJ.N. A multi-state analysis of postpartum readmissions in the United States.Am. J. Obstet. Gynecol.20162151113.e1113.e1010.1016/j.ajog.2016.01.17427829570
     [Google Scholar]
  11. La RosaM. JaukV. SaadeG.R. BoggessK. LongoS. ClarkE.A.S. EsplinS. ClearyK. WapnerR. LetsonK. OwensM.Y. BlackwellS. SzychowskiJ.M. AndrewsW. TitaA.T. Incidence and risk factors for hospital readmission or unexpected visits in women undergoing unscheduled cesarean delivery.Am. J. Perinatol.201936111115111910.1055/s‑0039‑168339130877684
     [Google Scholar]
  12. KimberlyB.G. TaylorH. AmyB. ElizabethA.H. Postpartum hospital readmissions and emergency department visits among high-risk, medicaid-insured women in New York City.Journal of Women's Health.202231913051313
     [Google Scholar]
  13. ClappM.A. RobinsonJ.N. LittleS.E. The relationship between the rising cesarean delivery and postpartum readmission rates.J. Perinatol.201737435535910.1038/jp.2016.25228079871
     [Google Scholar]
  14. OrganizationW.H. WHO recommendations non-clinical interventions to reduce unnecessary caesarean sections.World Health Organization2018
     [Google Scholar]
  15. FatuÅ. Correlation between cesarean section and perinatal mortality rate.Acta Med. Salin.2019491
     [Google Scholar]
  16. PetersJ.P.M. HooftL. GrolmanW. StegemanI. Reporting quality of systematic reviews and meta-analyses of otorhinolaryngologic articles based on the PRISMA statement.PLoS One2015108e013654010.1371/journal.pone.013654026317406
     [Google Scholar]
  17. WellsG.A. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses.Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
  18. LefebvreC. Cochrane handbook for systematic reviews of interventions.Oxfordshire, UKThe Cochrane Collaboration2011
     [Google Scholar]
  19. WebbD.A. RobbinsJ.M. Mode of delivery and risk of postpartum rehospitalization.JAMA20032891464710.1001/jama.289.1.46‑b12503975
     [Google Scholar]
  20. LiuS. HeamanM. JosephK.S. ListonR.M. HuangL. SauveR. KramerM.S. Risk of maternal postpartum readmission associated with mode of delivery.Obstet. Gynecol.2005105483684210.1097/01.AOG.0000154153.31193.2c15802414
     [Google Scholar]
  21. OddieS.J. HammalD. RichmondS. ParkerL. Early discharge and readmission to hospital in the first month of life in the Northern Region of the UK during 1998: A case cohort study.Arch. Dis. Child.200590211912410.1136/adc.2003.04076615665161
     [Google Scholar]
  22. DeclercqE. BargerM. CabralH.J. EvansS.R. KotelchuckM. SimonC. WeissJ. HeffnerL.J. Maternal outcomes associated with planned primary cesarean births compared with planned vaginal births.Obstet. Gynecol.2007109366967710.1097/01.AOG.0000255668.20639.4017329519
     [Google Scholar]
  23. BelfortM.A. Hospital readmission after delivery: Evidence for an increased incidence of nonurogenital infection in the immediate postpartum period.Am J Obstet Gyneco2010202135.e135.e7
     [Google Scholar]
  24. FordJ.B. AlgertC.S. MorrisJ.M. RobertsC.L. Decreasing length of maternal hospital stay is not associated with increased readmission rates.Aust. N. Z. J. Public Health201236543043410.1111/j.1753‑6405.2012.00882.x23025363
     [Google Scholar]
  25. YoungB.C. MaddenE. BryantA.S. What happens after the puerperium? Analysis of “late” postpartum readmissions in California.Open J. Obstet. Gynecol.20155312312710.4236/ojog.2015.53016
     [Google Scholar]
  26. BatraP. FridmanM. LengM. GregoryK.D. Emergency department care in the postpartum period: California births, 2009–2011.Obstet. Gynecol.201713051073108110.1097/AOG.000000000000226929016513
     [Google Scholar]
  27. WenT. NicoleM.K. MarkA.C. MaryE.D'A. JasonD.W. FrankA. WilliamJ.M. AlexanderM.F. Fragmentation of postpartum readmissions in the United States.Am J Obstet Gynecol.20202232252.e1252.e1410.1016/j.ajog.2020.01.022
     [Google Scholar]
  28. PatelS. RodriguezA.N. MaciasD.A. MorganJ. KrausA. SpongC.Y. A gap in care? Postpartum women presenting to the emergency room and getting readmitted.Am. J. Perinatol.202037141385139210.1055/s‑0040‑171217032473598
     [Google Scholar]
  29. GirsenA. LeonardS.A. CarmichaelS.L. GibbsR.S. ButwickA. Hospital readmissions after postpartum emergency department visit.Am. J. Obstet. Gynecol.20222261S517S51810.1016/j.ajog.2021.11.853
     [Google Scholar]
  30. KauffmanE. KlineC.R. DwyerE.R. Kline-SharpeC. AlbrightC.M. SouterV. 836 Postpartum readmission: Risk factors and diagnoses.Am. J. Obstet. Gynecol.20212242S520S52110.1016/j.ajog.2020.12.859
     [Google Scholar]
  31. MallaR. ManandharR. Puerperal morbidities after delivery in a tertiary care referral hospital of nepal.Med. J. Shree Birendra Hosp.201715281210.3126/mjsbh.v15i2.17198
     [Google Scholar]
  32. OphirE. StrulovA. SoltI. MichlinR. BuryanovI. BornsteinJ. Delivery mode and maternal rehospitalization.Arch. Gynecol. Obstet.2008277540140410.1007/s00404‑007‑0476‑417922286
     [Google Scholar]
  33. HungH.W. YangP.Y. YanY.H. JouH.J. LuM.C. WuS.C. Increased postpartum maternal complications after cesarean section compared with vaginal delivery in 225 304 Taiwanese women.J. Matern. Fetal Neonatal Med.201629101665167210.3109/14767058.2015.105980626135778
     [Google Scholar]
  34. MoudiF.M.Z. YaghmaeiM. Relationship between type of delivery and cause of hospitalization in postpartum period.J Guil Uni Med Sci200716614450
     [Google Scholar]
  35. HebertP.R. ReedG. EntmanS.S. MitchelE.F.Jr BergC. GriffinM.R. Serious maternal morbidity after childbirth: Prolonged hospital stays and readmissions.Obstet. Gynecol.199994694294710.1097/00006250‑199912000‑0000810576180
     [Google Scholar]
  36. LiuS. HeamanM. KramerM.S. DemissieK. WenS.W. MarcouxS. Length of hospital stay, obstetric conditions at childbirth, and maternal readmission: A population-based cohort study.Am. J. Obstet. Gynecol.2002187368168710.1067/mob.2002.12576512237648
     [Google Scholar]
  37. Lydon-RochelleM. HoltV.L. MartinD.P. EasterlingT.R. Association between method of delivery and maternal rehospitalization.JAMA2000283182411241610.1001/jama.283.18.241110815084
     [Google Scholar]
  38. KoroukianS.M. Relative risk of postpartum complications in the Ohio Medicaid population: Vaginal versus cesarean delivery.Med. Care Res. Rev.200461220322410.1177/107755870326012315155052
     [Google Scholar]
  39. LethR.A. MøllerJ.K. ThomsenR.W. UldbjergN. NørgaardM. Risk of selected postpartum infections after cesarean section compared with vaginal birth: A five-year cohort study of 32,468 women.Acta Obstet. Gynecol. Scand.200988997698310.1080/0001634090314740519642043
     [Google Scholar]
  40. PallasmaaN. EkbladU. GisslerM. Severe maternal morbidity and the mode of delivery.Acta Obstet. Gynecol. Scand.200887666266810.1080/0001634080210876318568466
     [Google Scholar]
  41. WangB. ZhouL. CoulterD. LiangH. ZhongY. GuoY. ZhuL. GaoX. YuanW. GaoE. Effects of caesarean section on maternal health in low risk nulliparous women: A prospective matched cohort study in Shanghai, China.BMC Pregnancy Childbirth20101017810.1186/1471‑2393‑10‑7821122153
     [Google Scholar]
  42. MozhganS.N.K. ShararehJ. AlirezaA. The outcomes of natural childbirth and C-section on the mother and infant’s health in selected hospitals in Tehran.Intern Med Today 2012182512
     [Google Scholar]
  43. AbisowoO.Y.A.A.O.A.O. Pattern of postpartum re-admission in lagos, Nigeria.Int. J. Recent Sci. Res.201910103555435558
     [Google Scholar]
  44. WangC.Y. YeeL.M. FeinglassJ.M. Delivery complications and postpartum hospital use in California.Womens Health Issues2022321576610.1016/j.whi.2021.08.00434580022
     [Google Scholar]
  45. MascarelloK.C. HortaB.L. SilveiraM.F. Maternal complications and cesarean section without indication: Systematic review and meta-analysis.Rev. Saude Publica20175110510.11606/S1518‑8787.201705100038929166440
     [Google Scholar]
  46. BordersN. After the afterbirth: A critical review of postpartum health relative to method of delivery.J. Midwifery Womens Health200651424224810.1016/j.jmwh.2005.10.01416814217
     [Google Scholar]
  47. WangE. GlazerK.B. HowellE.A. JanevicT.M. Social determinants of pregnancy-related mortality and morbidity in the United States.Obstet. Gynecol.2020135489691510.1097/AOG.000000000000376232168209
     [Google Scholar]
  48. SultanP. SharawiN. BlakeL. HabibA.S. BrookfieldK.F. CarvalhoB. Impact of enhanced recovery after cesarean delivery on maternal outcomes: A systematic review and meta-analysis.Anaesth. Crit. Care Pain Med.202140510093510.1016/j.accpm.2021.10093534390864
     [Google Scholar]
  49. MitchellK.A. Care of the postpartum patient in the emergency department: A systematic review with implications for maternal mortality.Am J Perinatol202340548950710.1055/s‑0041‑1732455
     [Google Scholar]
  50. Liu S, Heaman M, Joseph KS, Liston RM, Huang L, Sauve R, et al. Risk of maternal postpartum readmission associated with mode of delivery. Obstet Gynecol 2005; 105(4): 836-42.
/content/journals/cwhr/10.2174/0115734048259364230926093806
Loading
The Association of the Mode of Delivery and Maternal Postpartum Readmission: A Systematic Review and Meta-analysis
Current Women's Health Reviews 21, e290124226460 (2025); https://doi.org/10.2174/0115734048259364230926093806
/content/journals/cwhr/10.2174/0115734048259364230926093806
/content/journals/cwhr/10.2174/0115734048259364230926093806
Loading

Data & Media loading...

Supplements

PRISMA checklist is available as supplementary material on the publisher’s website along with the published article.

file format download Download

  • Article Type:     Research Article
Keyword(s): cesarean delivery; confidence intervals; deep vein thrombosis; genitourinary condition; mode of delivery; Postpartum readmission

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test