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Am J Perinatol 2015; 32(09): 825-832
DOI: 10.1055/s-0034-1543953
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Risk Factors for Prolonged Postpartum Length of Stay Following Cesarean Delivery

Yair J. Blumenfeld
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Yasser Y. El-Sayed
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Deirdre J. Lyell
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Lorene M. Nelson
2   Department of Health Research and Policy, Stanford University, Stanford, California
,
Alexander J. Butwick
3   Department of Anesthesia, Stanford University School of Medicine, Stanford, California
› Author Affiliations
Further Information

Publication History

12 August 2014

11 November 2014

Publication Date:
16 January 2015 (online)

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Abstract

Objective This study aims to identify risk factors for prolonged postpartum length of stays (LOS) after cesarean delivery (CD).

Study Design Patients undergoing CD were sourced from a multicenter registry of 19 academic centers between 1999 and 2002 (n = 57,067). Prolonged postpartum LOS was defined as a hospitalization duration ≥ 90th centile. Maternal, antepartum, perioperative, and neonatal variables were compared between women with and without prolonged postpartum LOS.

Results The 90th centile for postpartum LOS was 4 days, with 14,954 women experiencing prolonged postpartum LOS. Women with perioperative complications had the highest independent risk for a prolonged postpartum LOS: ileus (adjusted odds ratio [aOR] = 12.28; 95% confidence interval CI = 8.98–16.8); endometritis (aOR = 10.45; 95% CI = 9.51–11.5), and wound complications (aOR = 5.49; 95% CI = 4.54–6.63). Several antepartum, perioperative, and neonatal variables were associated with a prolonged postpartum LOS.

Conclusion Perioperative complications had the highest risk for prolonged LOS after CD. Strategies to reduce perioperative complications are needed to decrease the health care burden of prolonged post-CD LOS.

Keywords

cesarean - postpartum length of stay - prolonged

Note

The article was presented in poster format at: 34th Annual Meeting of the Society for Maternal-Fetal Medicine; February, 2014; New Orleans, LA and 46th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, May, 2014; Toronto, Canada.


Contribution to Authorship


Y. B., D. L., Y. E. S., and A. J. B. assisted with conception of the study, study design, data analysis, and article writing. L. M. N. assisted with data analysis and article writing.


This study was given a waiver of exemption from the Stanford University Institutional Review Board approval as the Caesarean registry dataset contains deidentified data.