Title:The Association of the Mode of Delivery and Maternal Postpartum Readmission: A Systematic Review and Meta-analysis
Volume: 21
Issue: 3
Author(s): Azam Maleki, Samaneh Youseflu*, Behnaz Molaei, Ensiyeh Jenabi and Mohammad AsghariJafarabadi
Affiliation:
- Department of
Midwifery and Reproductive Health, Isfahan University of Medical Sciences, Isfahan, Iran
Keywords:
Postpartum readmission, mode of delivery, cesarean delivery, deep vein thrombosis, genitourinary condition, confidence intervals.
Abstract:
Background: Postpartum readmission is one of the metrics for assessing the quality of
health services. There is inconsistent evidence about postpartum readmission and complications
by mode of delivery.
Objective: We applied a meta-analysis to investigate whether the mode of delivery is associated
with postpartum readmission or complications.
Methods: We systematically searched main English databases for studies published up to June
2022. The Newcastle–Ottawa scale (NOS) was used to assess the quality of observational studies.
The heterogeneity of included studies was determined using the I2 statistic and Begg’s and Egger’s
tests for publication bias, respectively. Results of the random-effects meta-analysis were presented
using odds ratio (OR) estimates with 95% confidence intervals (CI). The Stata software version
16 was used for data analysis.
Results: In total, 18 studies with 514,577 subjects were suitable for reviewing maternal postpartum
readmission by mode of delivery. Our findings show that cesarean delivery is a risk factor for
increasing postpartum readmission than the vaginal delivery method (overall OR =1.42, CI 95%
1.22, 1.63, I2= 99.7%, p = 0.001). This chance was increased in primary cesarean (OR=2). Postpartum
hemorrhage and breast infection did not have risk factors for postpartum readmission. While
cardiopulmonary condition, deep vein thrombosis (DVT), genitourinary condition, and wound
complication were risk factors among causes.
Conclusion: Cesarean delivery is one of the most important risk factors for postpartum readmission,
especially both childbirth-related/non-related complications causes. Therefore, it is necessary
to revise the schedule of postpartum visits based on the type of delivery.