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Implications of a Reduced Length of Postpartum Hospital Stay on Maternal and Neonatal Readmissions, an Observational Study

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Abstract

Introduction

Reducing the Length Of postpartum Stay (LOS) is associated with lower hospital costs, a major reason for initiating federal projects in Belgium. Disadvantages following the reduction of LOS are the risks of maternal and neonatal readmissions. This study compares readmissions with or without reduced LOS, by introducing the KOZI&Home program in the university hospital Brussels.

Methods

This is an observational study comparing the readmission rates of the length of postpartum hospital stay between two groups: the non-KOZI&Home group (> 2 days for vaginal birth and > 4 days for caesarean section) and KOZI&Home group (≤ 2 days for vaginal birth and ≤ 4 days for caesarean section). A follow-up period of 16 weeks was set up.

Results

The maternal readmission rate was 4,8% for the non-KOZI&Home group (n = 332) and 3.3% for the KOZI&Home group (n = 253). Neonatal readmission rates were 7.2% and 15.9% respectively. After controlling influencing factors in a multivariate model for maternal and neonatal readmissions, there were no statistical significant differences. Factors negatively affecting neonatal readmissions are (1) dismissal period October-January (OR:3.22;95% CI 1.10–9.42) and (2) low education level (OR:3.44;95% CI 1.54–7.67), for maternal readmissions it concerns whether or not LOS is known (OR:3.26;95% CI 1.21–8.81).

Discussion

There is no effect of the KOZI&Home program on maternal nor neonatal readmission rates. Systematically informing about postpartum LOS antenatally will enforce preparation and is important to reduce maternal readmissions. Personalized information should be given to women discharged in the period October-January and to those with a lower education level, in order to reduce neonatal readmissions.

Significance

What is already known on this subject? Reducing the ‘length of stay’ after giving birth is known, for example, to reduce costs and for having a more family-centered approach. Above the known advantages, there is also some conflicting literature about the disadvantages. Some of the articles shown a higer readmission rate, and others no difference in readmission rates.

What this study adds? The influencing factors of maternal and neonatal readmissions are checked, in order to reduce the number of readmissions in the future. Systematically informing about postpartum LOS antenatally will enforce preparation and is important to reduce maternal readmissions. Personalized information should be given to women discharged in the period October-January and to those with a lower education level, in order to reduce neonatal readmissions.

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Acknowledgements

First of all, we would like to thank all women that participated this study. Without them, this study could not have taken place. Furthermore, we would like to thank Mrs An Vanspringel and Mrs Peggy Uyttersprot for extracting specific data from women’s medical records. We also gratefully acknowledge Leander Scheir, for checking this work for spelling, grammar and clarity.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium

    Amber Stas

  2. Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium

    Maria Breugelmans, Leonardo Gucciardo, Monika Laubach & Gilles Faron

  3. Maternity ward UZ Brussel, Jette, Belgium

    Lynn Geerinck & An Spinnoy

  4. Nursing and Midwifery, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking, Universiteit Antwerpen, Antwerp, Belgium

    Julie Laats & Katrien Beeckman

  5. Interfaculty Center Data Processing & Statistics, Universitair Ziekenhuis Brussel, Brussels, Belgium

    Sven Van Laere

  6. Nursing and Midwifery Research Group, Department of Public Health, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium

    Katrien Beeckman

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  1. Amber Stas
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Stas, A., Breugelmans, M., Geerinck, L. et al. Implications of a Reduced Length of Postpartum Hospital Stay on Maternal and Neonatal Readmissions, an Observational Study. Matern Child Health J 27, 1949–1960 (2023). https://doi.org/10.1007/s10995-023-03667-8

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