Obesity ups postpartum hospital use in women without comorbidities

Pregnant women with no other comorbidities but who have an elevated BMI tend to have greater postpartum hospital use (PHU), reveals a study.

Investigators examined birth certificates from 2016 to 2018 and discharge data on 178,729 New York City births without International Classification of Diseases, Tenth Revision (ICD-10) codes at delivery for diabetes; hypertension; placental disease; anaemia; thyrotoxicosis; bariatric surgery; and pulmonary, cardiac, renal, bleeding, autoimmune, digestive, neuromuscular, mental, or substance-use disorders.

PHU was defined as one or more readmission or emergency department visit within 30 days of delivery discharge. ICD-10 codes were used to specify postpartum hypertension, infection, or haemorrhage during PHU (ie, cause-specific PHU), which are leading causes of death. Finally, multivariable logistic regression was used to examine the associations between prepregnancy BMI and PHU.

The incidence of PHU was 3.7 percent in women with normal weight, 5.1 percent in those with overweight, 6.3 percent in those with class 1 or 2 obesity, and 9.1 percent in those with class 3 obesity. The association between increased BMI and PHU persisted after adjustment.

Obesity significantly correlated with cause-specific PHU of postpartum hypertension (adjusted odds ratio [aOR], 2.2, 95 percent confidence limits [CL], 1.8–2.7; normal weight as reference) and wound infection (aOR, 1.5, 95 percent CL, 1.2–1.8), but not haemorrhage (aOR, 0.9, 95 percent CL, 0.7–1.3), mastitis, or genitourinary infection (aOR, 1.1, 95 percent CI, 0.9–1.3).

“[These] findings can inform obstetric management to reduce morbidity during the critical fourth trimester,” the investigators said.