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Delivery Complications and Postpartum Hospital Use in California Open Access (recommended)


Resource type(s)
Masters Thesis
severe mental morbidity
quality of care
emergency department use
Attribution 4.0 International

Wang, Chen
Introduction: Research on maternal birth outcomes rarely includes postpartum complications with longitudinally linked patient data. We analyze characteristics associated with delivery complications and postpartum hospital use for women in California. Methods: This population-based cohort study is based on California hospital discharge data. International Classification of Diseases 10th Revision codes were used to categorize the incidence of severe maternal morbidity (SMM) and other, route-specific delivery complications as well as preexisting and pregnancy-related conditions and principal diagnoses for postpartum hospital visits. Postpartum hospital use is a composite outcome defined as Emergency Department (ED) visits or hospital readmissions within 90 days of delivery discharge. Multivariable Poisson regression analyses were used to estimate the association of patient-level and hospital-level characteristics with the likelihood of postpartum hospital use. Results: In 2017, there were 457,498 delivery admissions in California-licensed hospitals of which we analyzed 348,828 index deliveries with linked patient data. Among linked deliveries, 34,825 (10.0%) had an inpatient admission (4,206, 1.2%) or an ED visit (30,371, 9.2%) within 90 days of delivery discharge. Delivery complications included a 1.7% SMM rate, 7.9% rate of vaginal delivery complications, 10.0% of rate of cesarean delivery complications, and 2.9% frequency of long lengths of stay, all of which were significantly associated with postpartum hospital use. In addition, preexisting and pregnancy-related conditions, undergoing cesarean delivery, being less than 18 years old, non-Hispanic Black, or from high poverty ZIP codes or having Medicaid coverage, were also significant risk factors for postpartum hospital use. Discussion: One in ten women had a hospital visit within 90 days postpartum. Improving postpartum care is an urgent public health priority.
DigitalHub. Galter Health Sciences Library & Learning Center
Date Created
Subject: MESH
Postpartum Period
Pregnancy Complications
Cohort Studies
Maternal Mortality
Patient Readmission
Emergency Service, Hospital
Quality of Health Care
Subject: Geographic Name

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