Hsin-Wen Hung1, Pei-Yin Yang2, Yuan-Horng Yan3, Hei-Jen Jou4, Mei-Chun Lu2,3, Shiao-Chi Wu5. 1. a Center of Quality Management, Ditmanson Medical Foundation Chia-Yi Christian Hospital , Chiayi , Taiwan . 2. b Department of Obstetrics and Gynecology , Ditmanson Medical Foundation Chia-Yi Christian Hospital , Chiayi , Taiwan . 3. c Department of Medical Research , Ditmanson Medical Foundation Chia-Yi Christian Hospital , Chiayi , Taiwan . 4. d Department of Obstetrics and Gynecology , Taiwan Adventist Hospital , Taipei , Taiwan , and. 5. e Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University , Taipei , Taiwan.
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.
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.
Authors: Jesmin Sultana; Ipsita Sutradhar; Musarrat Jabeen Rahman; Abdullah Nurus Salam Khan; Mohiuddin Ahsanul Kabir Chowdhury; Enam Hasib; Charu Chhetri; S M Hasan Mahmud; Tahsin Kashem; Sanjeev Kumar; Zaw Toe Myint; Mahbubur Rahman; Tarique Md Nurul Huda; Shams El Arifeen; Sk Masum Billah Journal: Int J Environ Res Public Health Date: 2022-01-27 Impact factor: 3.390