Postpartum Hospital Readmissions With and Without Severe Maternal Morbidity Within 1 Year of Birth, Oregon, 2012-2017.
Postpartum Hospital Readmissions With and Without Severe Maternal Morbidity Within 1 Year of Birth, Oregon, 2012-2017.
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2012-2017 年俄勒冈州出生后 1 年内有或没有严重孕产妇发病的产后再入院情况。
DOI：
10.1093/aje/kwac183
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发表时间：
2023
影响因子：
5
通讯作者：
Snowden,JonathanM
中科院分区：
文献类型：
--
作者：
Kaufman,Menolly;McConnell,KJohn;Carmichael,SuzanL;Rodriguez,MariaI;Richardson,Dawn;Snowden,JonathanM
产后再入院（PPR）是医院分娩后孕产妇发病率的重要标志。大多数严重的孕产妇发病率（SMM）事件导致住院，但大多数PPR没有SMM的证据。产后6周后PPR和SMM的情况知之甚少。我们研究了产后12个月内产妇人口统计学和临床因素与PPR的关系。我们将PPR分为有或无SMM证据，以评估风险因素和时间是否不同。使用俄勒冈州所有付款人所有索赔数据库，我们分析了2012-2017年的医院分娩。我们使用对数二项回归来估计母体因素和PPR之间的关联。我们的最终分析样本包括158，653名新生儿。总体而言，2.6%（n= 4，141）的分娩涉及产后12个月内至少1次再入院（808例（19.5%的PPR）伴SMM）。分娩时的SMM是PPR伴SMM的最强风险因素（风险比（RR）= 5.55，95%置信区间（CI）：4.14，7.44）。无SMM的PPR有许多风险因素，包括任何精神健康诊断（RR = 2.10，95%CI：1.91，2.30），慢性高血压（RR = 2.17，95% CI：1.85，2.55），和孕前糖尿病（RR = 2.85，95% CI：2.47，3.30），均与分娩时SMM相当（RR = 1.89，95% CI：1.49，2.40）。
Postpartum readmissions (PPRs) represent a critical marker of maternal morbidity after hospital childbirth. Most severe maternal morbidity (SMM) events result in a hospital admission, but most PPRs do not have evidence of SMM. Little is known about PPR and SMM beyond the first 6 weeks postpartum. We examined the associations of maternal demographic and clinical factors with PPR within 12 months postpartum. We categorized PPR as being with or without evidence of SMM to assess whether risk factors and timing differed. Using the Oregon All Payer All Claims database, we analyzed hospital births from 2012–2017. We used log-binomial regression to estimate associations between maternal factors and PPR. Our final analytical sample included 158,653 births. Overall, 2.6% (n= 4,141) of births involved at least 1 readmission within 12 months postpartum (808 (19.5% of PPRs) with SMM). SMM at delivery was the strongest risk factor for PPR with SMM (risk ratio (RR) = 5.55, 95% confidence interval (CI): 4.14, 7.44). PPR without SMM had numerous risk factors, including any mental health diagnosis (RR = 2.10, 95% CI: 1.91, 2.30), chronic hypertension (RR = 2.17, 95% CI: 1.85, 2.55), and prepregnancy diabetes (RR = 2.85, 95% CI: 2.47, 3.30), all which were on par with SMM at delivery (RR = 1.89, 95% CI: 1.49, 2.40).