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The Risk of Readmission after Early Postpartum Discharge during the COVID-19 Pandemic.
Gulersen, Moti; Husk, Gregg; Lenchner, Erez; Blitz, Matthew J; Rafael, Timothy J; Rochelson, Burton; Chakravarthy, Shruti; Grunebaum, Amos; Chervenak, Frank A; Fruhman, Gary; Jones, Monique De Four; Schwartz, Benjamin; Nimaroff, Michael; Bornstein, Eran.
  • Gulersen M; Department of Obstetrics and Gynecology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
  • Husk G; Department of Medical Informatics, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, New York, New York.
  • Lenchner E; Department of Biostatistics and Data Management, NYU Rory Meyers College of Nursing, New York, New York.
  • Blitz MJ; Department of Obstetrics and Gynecology, Southside Hospital, Zucker School of Medicine at Hofstra/Northwell, Bay Shore, New York.
  • Rafael TJ; Department of Obstetrics and Gynecology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
  • Rochelson B; Department of Obstetrics and Gynecology, North Shore University Hospital, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
  • Chakravarthy S; Department of Biostatistics and Data Management, NYU Rory Meyers College of Nursing, New York, New York.
  • Grunebaum A; Department of Obstetrics and Gynecology, Staten Island University Hospital, Zucker School of Medicine at Hofstra/Northwell, Staten Island, New York.
  • Chervenak FA; Department of Obstetrics and Gynecology, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, New York, New York.
  • Fruhman G; Department of Obstetrics and Gynecology, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, New York, New York.
  • Jones MF; Department of Biostatistics and Data Management, NYU Rory Meyers College of Nursing, New York, New York.
  • Schwartz B; Department of Obstetrics and Gynecology, Staten Island University Hospital, Zucker School of Medicine at Hofstra/Northwell, Staten Island, New York.
  • Nimaroff M; Department of Obstetrics and Gynecology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Queens, New York.
  • Bornstein E; Department of Obstetrics and Gynecology, Southside Hospital, Zucker School of Medicine at Hofstra/Northwell, Bay Shore, New York.
Am J Perinatol ; 39(4): 354-360, 2022 03.
Article in English | MEDLINE | ID: covidwho-1565753
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..
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Discharge / Patient Readmission / Postnatal Care / Medicaid / Obesity, Maternal / COVID-19 / Insurance, Health Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Pregnancy Country/Region as subject: North America Language: English Journal: Am J Perinatol Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Discharge / Patient Readmission / Postnatal Care / Medicaid / Obesity, Maternal / COVID-19 / Insurance, Health Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Pregnancy Country/Region as subject: North America Language: English Journal: Am J Perinatol Year: 2022 Document Type: Article