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Affiliation
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Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden. |
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Abstract
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AIMS AND OBJECTIVES: The aim of the study was to (i) reveal care-seeking patterns of emergency room (ER) visits within 30 days following childbirth (i.e., identify risk factors that trigger contact with ER, visit rate and diagnoses) and (ii) suggest clinical implications for postnatal follow-up.
DESIGN: The study had a longitudinal design; it used anonymized data from a county council database on all women in Stockholm County, Sweden, who gave birth in 2013.
METHODS: Descriptive and inferential data analysis methods were used. Cox regression was applied to these variables: age when giving birth, diagnostic codes at birth, care encounters and types (e.g. visits or hospital admissions), day of discharge and care organization and type. The data covered the period from childbirth through a 30-day period following discharge from hospital.
RESULTS: The database contained 28,963 births and 59,202 health- or medical-care encounters. Of these encounters, 50.3% (n = 29,774) were planned visits to hospital postnatal care units within 7 days following discharge and 1.2% (n = 681) were admissions to hospitals. Of all women who gave birth, 12.2% (n = 3533) visited the ER at least once. The number of visits peaked at day 6 following discharge. These factors significantly increased risk for ER visits: caesarean, assisted birth and sphincter injury.
CONCLUSIONS: ER visits occurred most commonly immediately following discharge when there were no routine check-ups. Greater risk of ER visits - following caesareans, assisted childbirths or sphincter injuries - indicated that early support for women with childbirth complications should be improved upon discharge from hospital. Other multiple risk factors for ER visits might exist. RELEVANCE TO CLINICAL PRACTICE: Many ER visits could be prevented through early, more qualified, appropriate follow-up via maternity care systems and effective midwifery interventions. These initiatives could enhance care continuity and facilitate postpartum recovery. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Language: en |