Patient Risk Factors for Postpartum Re-presentation for Evaluation [17C

Abstract

INTRODUCTION: The objective of our study was to identify risk factors for postpartum readmission. We hypothesized that patients who re-present for evaluation have identifiable demographic and obstetric risk factors. METHODS: This retrospective cohort study was conducted at a large urban US medical center. Demographic and pregnancy data were extracted for all patients who delivered within the study window (2012–2018). Data was compared between patients who re-presented to the emergency department (ED) for evaluation within the first 30 days following discharge from their delivery admission versus those that delivered within the study window but did not re-present for reevaluation. RESULTS: A total of 45, 342 women delivered within the study window. 1089 women re-presented for reevaluation (2.4%). Results from univariate analyses offer support for the idea that women who re-presented were more likely to be black or Latina, obese, have public insurance, prefer a language other than English, require an interpreter, and less likely to have a partner. They were also more likely to be primiparous, deliver preterm, by cesarean, and with admission to the NICU. A longer length of stay was significantly associated with re-evaluation, even when broken down by delivery type. Race, delivery method, gestational age, BMI, parity, and length of stay remained significant after adjusting for all other factors in a multivariable analysis. CONCLUSION: There are several identifiable demographic and obstetric risk factors for re-presentation following discharge after delivery. This has implications as to how we may optimize postpartum counseling and follow up to decrease readmission rates in groups at higher risk.