The Risk of Readmission after Early Postpartum Discharge during the COVID-19 Pandemic

Abstract

Objective To determine whether early postpartum discharge during the coronavirus disease 2019 (COVID-19) pandemic was associated with a change in the odds of maternal postpartum readmissions.

Study Design This is a retrospective analysis of uncomplicated postpartum low-risk women in seven obstetrical units within a large New York health system. We compared the rate of postpartum readmissions within 6 weeks of delivery between two groups: low-risk women who had early postpartum discharge as part of our protocol during the COVID-19 pandemic (April 1–June 15, 2020) and similar low-risk patients with routine postpartum discharge from the same study centers 1 year prior. Statistical analysis included the use of Wilcoxon's rank-sum and chi-squared tests, Nelson–Aalen cumulative hazard curves, and multivariate logistic regression.

Results Of the 8,206 patients included, 4,038 (49.2%) were patients who had early postpartum discharge during the COVID-19 pandemic and 4,168 (50.8%) were patients with routine postpartum discharge prior to the COVID-19 pandemic. The rates of postpartum readmissions after vaginal delivery (1.0 vs. 0.9%; adjusted odds ratio [OR]: 0.75, 95% confidence interval [CI]: 0.39–1.45) and cesarean delivery (1.5 vs. 1.9%; adjusted OR: 0.65, 95% CI: 0.29–1.45) were similar between the two groups. Demographic risk factors for postpartum readmission included Medicaid insurance and obesity.

Conclusion Early postpartum discharge during the COVID-19 pandemic was associated with no change in the odds of maternal postpartum readmissions after low-risk vaginal or cesarean deliveries. Early postpartum discharge for low-risk patients to shorten hospital length of stay should be considered in the face of public health crises.

Key Points

• Early postpartum discharge was not associated with an increase in odds of hospital readmissions after vaginal delivery.

• Early postpartum discharge was not associated with an increase in odds of hospital readmissions after cesarean delivery.

• Early postpartum discharge for low-risk patients should be considered during a public health crisis.

Keywords

SARS-CoV-2 - coronavirus - pregnancy - early discharge - postpartum discharge - postpartum readmission - pandemic

Publikationsverlauf

Eingereicht: 16. Oktober 2020

Angenommen: 04. Oktober 2021

Artikel online veröffentlicht:
10. Dezember 2021

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