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Epidemiology of readmissions in early infancy following nonelective cesarean delivery

Journal of Perinatology volume 41, pages 24–31 (2021)Cite this article

Subjects

Abstract

Objective

Determine incidence and risk factors for readmissions in early infancy.

Study design

Secondary analysis of data from the Cesarean Section Optimal Antibiotic Prophylaxis trial. All unplanned revisits (unplanned clinic, ER visits, and hospital readmissions) and hospital readmissions (initial discharge to 3-month follow-up) were analyzed.

Results

295 (15.9%) of 1850 infants had revisits with risk factors being ethnicity (adjusted odds ratio (aOR): 0.6 for Hispanic), maternal postpartum antibiotics (1.89), azithromycin treatment (1.22), small for gestational age (1.68), apnea (3.82), and hospital stay after birth >90th percentile (0.49). 71 (3.8%) of 1850 infants were readmitted with risk factors being antenatal steroids (aOR 2.49), elective repeat C/section (0.72), postpartum maternal antibiotics (2.22), O2 requirement after delivery room (2.82), and suspected/proven neonatal sepsis (0.55).

Conclusion(s)

Multiple risk factors were identified, suggesting potential impact on the neonatal microbiome (maternal postpartum antibiotics) or issues related to access/cost of care (Hispanic ethnicity associated with fewer revisits).

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Fig. 1: Flow diagram of patient enrollment.

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Funding

This study is funded by NIH (R01 HD064729).

C/SOAP Consortium

Rachel LeDuke12, Janatha Grant12, Lee Ann Merin12, Marci Tew12, Gloria Adam12, Zhara Rahman12, Rebecca Quinn12, Yukiko Nakamura Orange13, Christopher Parks13, Richard Mailhot13, Robin Steele13, Sue Cliver13, Ashutosh Tamhane13, Karen Dorman14, Linda Manor14, Sue Pope14, Carmen Beamon15, Beth Morgan15, Ester Godbold16, Cecelia Recabarren16, Maria Bahena16, Brenda Aguillon16, Virginia Huaracha16, Maria Wilson-Jimenez16, Lisa Garcia16, Masoomeh Ehsani16, Sa Tran16, Christine Servay17, Barbara Conley17, Pat Pandya17, Elaine Lofland18, Kim Potthoff18, Vanessa Johnson19, Kedra Wallace19, James N. MartinJr19, Richard Ogletree19, Michael Varner20, Shanna Salmon20, Suzanne Timothy20, Amber Sowles20, Kim Hill20, Winter Redd20, Amanda Behunin21, Sandi Dellerman21, Michael Nunley21, Richard Cox21, Melissa Hofer21, Caroline Torres22, Connie Eng22, M. Hutchison23, Paula Givens23, Felecia Ortiz23, Vu Ta23, Christine Wong23, Michael George23.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA

    Namasivayam Ambalavanan

  2. Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA

    Victoria Jauk & Jeff M. Szychowski

  3. Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA

    Jeff M. Szychowski, William Andrews & Alan T. Tita

  4. Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA

    Kim A. Boggess

  5. Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA

    George Saade

  6. Department of Obstetrics and Gynecology, Ochsner Health System, New Orleans, LA, USA

    Sherri Longo

  7. Department of Obstetrics and Gynecology, University of Utah (S.E.) and Intermountain Health Care (S.E.), Salt Lake City, UT, USA

    Sean Esplin

  8. Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA

    Kirsten Cleary & Ronald Wapner

  9. Department of Obstetrics and Gynecology, Mission Hospital, Asheville, NC, USA

    Kellett Letson

  10. Department of Obstetrics and Gynecology, University of Mississippi, Jackson, MS, USA

    Michelle Owens

  11. Department of Obstetrics and Gynecology, University of Texas Health Sciences Center, Houston, TX, USA

    Sean Blackwell

  12. Clinical Coordination Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Rachel LeDuke, Janatha Grant, Lee Ann Merin, Marci Tew, Gloria Adam, Zhara Rahman & Rebecca Quinn

  13. Data Coordinating Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Yukiko Nakamura Orange, Christopher Parks, Richard Mailhot, Robin Steele, Sue Cliver & Ashutosh Tamhane

  14. UNC site, University of North Carolina, Chapel Hill, NC, USA

    Karen Dorman, Linda Manor & Sue Pope

  15. Wake Hospital site, University of North Carolina, Chapel Hill, NC, USA

    Carmen Beamon & Beth Morgan

  16. University of Texas Medical Branch, Galveston, TX, USA

    Ester Godbold, Cecelia Recabarren, Maria Bahena, Brenda Aguillon, Virginia Huaracha, Maria Wilson-Jimenez, Lisa Garcia, Masoomeh Ehsani & Sa Tran

  17. Ochsner Health System, New Orleans, LA, USA

    Christine Servay, Barbara Conley & Pat Pandya

  18. Mission Hospital, Ashville, NC, USA

    Elaine Lofland & Kim Potthoff

  19. University of Mississippi Medical Center, Jacksonville, MS, USA

    Vanessa Johnson, Kedra Wallace, James N. Martin Jr & Richard Ogletree

  20. University of Utah Health Sciences Center, Salt Lake City, UT, USA

    Michael Varner, Shanna Salmon, Suzanne Timothy, Amber Sowles, Kim Hill & Winter Redd

  21. Intermountain Healthcare sites, University of Utah Health Sciences Center, Salt Lake City, UT, USA

    Amanda Behunin, Sandi Dellerman, Michael Nunley, Richard Cox & Melissa Hofer

  22. Columbia University, New York, NY, USA

    Caroline Torres & Connie Eng

  23. UT Health Science Center Houston, Houston, TX, USA

    M. Hutchison, Paula Givens, Felecia Ortiz, Vu Ta, Christine Wong & Michael George

Authors
  1. Namasivayam Ambalavanan
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  8. Kirsten Cleary
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  9. Ronald Wapner
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  10. Kellett Letson
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Consortia

for the C/SOAP Consortium

  • Rachel LeDuke
  • , Janatha Grant
  • , Lee Ann Merin
  • , Marci Tew
  • , Gloria Adam
  • , Zhara Rahman
  • , Rebecca Quinn
  • , Yukiko Nakamura Orange
  • , Christopher Parks
  • , Richard Mailhot
  • , Robin Steele
  • , Sue Cliver
  • , Ashutosh Tamhane
  • , Karen Dorman
  • , Linda Manor
  • , Sue Pope
  • , Carmen Beamon
  • , Beth Morgan
  • , Ester Godbold
  • , Cecelia Recabarren
  • , Maria Bahena
  • , Brenda Aguillon
  • , Virginia Huaracha
  • , Maria Wilson-Jimenez
  • , Lisa Garcia
  • , Masoomeh Ehsani
  • , Sa Tran
  • , Christine Servay
  • , Barbara Conley
  • , Pat Pandya
  • , Elaine Lofland
  • , Kim Potthoff
  • , Vanessa Johnson
  • , Kedra Wallace
  • , James N. Martin Jr
  • , Richard Ogletree
  • , Michael Varner
  • , Shanna Salmon
  • , Suzanne Timothy
  • , Amber Sowles
  • , Kim Hill
  • , Winter Redd
  • , Amanda Behunin
  • , Sandi Dellerman
  • , Michael Nunley
  • , Richard Cox
  • , Melissa Hofer
  • , Caroline Torres
  • , Connie Eng
  • , M. Hutchison
  • , Paula Givens
  • , Felecia Ortiz
  • , Vu Ta
  • , Christine Wong
  •  & Michael George

Corresponding author

Correspondence to Namasivayam Ambalavanan.

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The authors declare that they have no conflict of interest.

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Members of the C/SOAP Consortium are listed below Acknowledgements

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Ambalavanan, N., Jauk, V., Szychowski, J.M. et al. Epidemiology of readmissions in early infancy following nonelective cesarean delivery. J Perinatol 41, 24–31 (2021). https://doi.org/10.1038/s41372-020-0730-1

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  • DOI: https://doi.org/10.1038/s41372-020-0730-1

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