American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 35.e1-35.e7 , January 2010

Hospital readmission after delivery: evidence for an increased incidence of nonurogenital infection in the immediate postpartum period

  • Michael A. Belfort, MD, PhD

      Affiliations

    • Hospital Corporation of America, Nashville, TN
    • Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT
    • Department of Maternal-Fetal Medicine, St. Mark's Hospital, Salt Lake City, UT
    • ,
  • Steven L. Clark, MD

      Affiliations

    • Hospital Corporation of America, Nashville, TN
    • Department of Maternal-Fetal Medicine, St. Mark's Hospital, Salt Lake City, UT
    • ,
  • George R. Saade, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX
    • ,
  • Kacie Kleja, MS

      Affiliations

    • Hospital Corporation of America, Nashville, TN
    • ,
  • Gary A. Dildy III, MD

      Affiliations

    • Hospital Corporation of America, Nashville, TN
    • Department of Maternal-Fetal Medicine, St. Mark's Hospital, Salt Lake City, UT
    • ,
  • Teelkien R. Van Veen, BS

      Affiliations

    • Department of Obstetrics and Gynecology, University Medical Center, Groningen, The Netherlands
    • ,
  • Efe Akhigbe, MD

      Affiliations

    • Hospital Corporation of America, Nashville, TN
    • ,
  • Donna R. Frye, RN, MN

      Affiliations

    • Hospital Corporation of America, Nashville, TN
    • ,
  • Janet A. Meyers, RN, MBA

      Affiliations

    • Hospital Corporation of America, Nashville, TN
    • ,
  • Shalece Kofford, RN, MPH

      Affiliations

    • Department of Maternal-Fetal Medicine, St. Mark's Hospital, Salt Lake City, UT

Received 1 May 2009 ,Revised 13 July 2009 ,Accepted 19 August 2009.

References 

  1. Liu S, Heaman M, Joseph KS, et al. Risk of maternal postpartum readmission associated with mode of delivery. Obstet Gynecol. 2005;105:836–842
  2. Lydon-Rochelle M, Holt VL, Martin DP, Easterling TR. Association between method of delivery and maternal rehospitalization. JAMA. 2000;283:2411–2416
  3. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare Fee-for-Service Program. N Engl J Med. 2009;360:418–428
  4. Office of Management and Budget: new study on hospital readmissions. http://www.whitehouse.gov/omb/blog/09/04/08/newstudyonhospitalreadmissionsAccessed June 1, 2009.
  5. Clark SL, Belfort MA, Dildy GA, et al. Maternal death in the 21st century: prevention and relationship to cesarean delivery. Am J Obstet Gynecol. 2008;199:36.e1–36.e5
  6. Clark SL, Belfort MA, Hankins GDV, et al. Variation in the rates of operative delivery in the United States. Am J Obstet Gynecol. 2007;196:526–527
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  9. Boggess KA, Watts DH, Hillier SL, Krohn MA, Benedetti TJ, Eschenbach DA. Bacteremia shortly after placental separation during cesarean delivery. Obstet Gynecol. 1996;87:779–784
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  11. Elenkov I, Wilder R, Bakalov V, et al. IL-12, TNF-alpha, and hormonal changes during late pregnancy and early postpartum: implications for autoimmune disease activity during these times. J Clin Endocrinol Metab. 2001;86:4933–4938
  12. Singh N, Perfect JR. Immune reconstitution syndrome and exacerbation of infections after pregnancy. Clin Infect Dis. 2007;45:1192–1199
  13. Gaunt G, Ramin K. Immunological tolerance of the human fetus. Am J Perinatol. 2001;18:299–312
  14. Poole J, Claman HN. Immunology of pregnancy: implications for the mother. Clin Rev Allergy Immunol. 2004;26:161–170
  15. Krasnow J, Tollerud D, Naus G, et al. Endometrial Th2 cytokine expression throughout menstrual cycle and early pregnancy. Hum Reprod. 1996;11:1747–1754
  16. Wilder R. Hormones, pregnancy, and autoimmune diseases. Ann NY Acad Sci. 1998;840:45–50
  17. Jamieson DJ, Theller RN, Rasmussen SA. Emerging infections and pregnancy. Emerg Infect Dis. 2006;12:1638–1643
  18. Gayat E, Lecarpentier E, Retout S, et al. Cough reflex sensitivity after elective Caesarean section under spinal anaesthesia and after vaginal delivery. Br J Anaesth. 2007;99:694–698
  19. Lähteenmäki M, Salo M, Tenovuo J, Vahlberg T. Effects of anaesthesia using endotracheal intubation or the laryngeal mask airway, or spinal anaesthesia, on oral mucosal host defences during minor surgery. Acta Anaesthesiol Scand. 2005;49:1318–1325

 Reprints not available from the authors.

 Authorship and contribution to the article is limited to the 10 authors indicated. There was no outside funding or technical assistance with the production of this article.

 Cite this article as: Belfort MA, Clark SL, Saade GR, et al. Hospital readmission after delivery: evidence for an increased incidence of nonurogenital infection in the immediate postpartum period. Am J Obstet Gynecol 2010;202:35.e1-7.

PII: S0002-9378(09)00955-7

doi: 10.1016/j.ajog.2009.08.029

American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 35.e1-35.e7 , January 2010

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