Increased postpartum maternal complications after cesarean section compared with vaginal delivery in 225 304 Taiwanese women. (18th May 2016)

• Record Type: Journal Article
• Authors: Hung, Hsin-Wen; Yang, Pei-Yin; Yan, Yuan-Horng; Jou, Hei-Jen; Lu, Mei-Chun; Wu, Shiao-Chi
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29:Number 10(2016)
• Page Start: 1665
• Page End: 1672
• Publication Date: 2016-05-18
• Subjects: Hemorrhages -- hospital volume -- modes of delivery -- obstetrician volume -- postpartum infections -- wounds; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2015.1059806
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : To compare the short-term maternal postpartum complications associated with cesarean section (CS), vaginal delivery (VD), repeated CS and vaginal birth after cesarean section (VBAC) in a large national sample. Methods : This was a population-based study of the Taiwan National Health Insurance Research Database (NHIRD). Outcomes include post-discharge (2 weeks) urinary tract infection (p-UTI), complications of obstetrical surgical wounds (p-wound) and postpartum hemorrhage (p-hemorrhage). A logistic regression model with generalized estimating equations were utilized, and adjustments were made for maternal and hospital characteristics. Results : The incidence of p-UTI was 0.79%. CS was associated with a significantly higher risk of p-UTI compared with VD (odds ratio [OR] 1.14; 95% confidence interval [CI], 1.003–1.29). The incidence of p-wound was 4.07%. CS and repeated CS were associated with a higher risk of p-wound compared with VD (OR 1.68; 95% CI, 1.28–2.21 and OR 1.64; 95% CI, 1.22–2.20, respectively). Age, maternal diseases and hospital and obstetrician volumes were associated with patient outcomes. Conclusions : Women with a delivery mode of CS have a higher risk of p-UTI and p-wound than women with VD. Maternal characteristics and hospital and obstetrician volumes may also influence postpartum outcomes.