Evidence map›Paper›PMID 33705999›Full record

ArticleAmerican journal of obstetrics & gynecology MFM2021

Risk factors for postpartum readmission among women after having a stillbirth.

Julia D DiTosto, Can Liu, Elizabeth Wall-Wieler, Ronald S Gibbs, Anna I Girsen, Yasser Y El-Sayed, Alexander J Butwick, Suzan L Carmichael

Open access · greenAbstract read
In one paragraph

Article in American journal of obstetrics & gynecology MFM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Association between stillbirth and severe maternal morbidity.American journal of obstetrics and gynecology · 2024
    Article
  2. Call for Improved Fourth Trimester Care After Stillbirth.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 2 countries.

Julia D DiTostoDepartment of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Ms DiTosto and Drs Gibbs, Girsen, and El-Sayed).
Can LiuDepartment of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (Dr Liu); Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Drs Liu, Wall-Wieler, and Carmichael).
Elizabeth Wall-WielerDivision of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Drs Liu, Wall-Wieler, and Carmichael).
Ronald S GibbsDepartment of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Ms DiTosto and Drs Gibbs, Girsen, and El-Sayed).
Anna I GirsenDepartment of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Ms DiTosto and Drs Gibbs, Girsen, and El-Sayed).
Yasser Y El-SayedDepartment of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Ms DiTosto and Drs Gibbs, Girsen, and El-Sayed).
Alexander J ButwickDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA (Dr Butwick).
Suzan L CarmichaelDivision of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Drs Liu, Wall-Wieler, and Carmichael). Electronic address: suzanc@stanford.edu.
Stanford University · US

Funding

Severe Maternal Morbidity: An Investigation of Racial-Ethnic Disparities, Social Disadvantage & Maternal WeightR01NR017020 · NINR · STANFORD UNIVERSITY · PI SUZAN L CARMICHAEL · 2018 to 2026
$5.2M
Maternal Health After Stillbirth: An Investigation of Postpartum Hospital Readmission in CaliforniaR03HD095034 · NICHD · STANFORD UNIVERSITY · PI CARMICHAEL, SUZAN L · 2018 to 2019
$157k
NICHD NIH HHS R03 HD095034NINR NIH HHS R01 NR017020
6 · The paper itself

Abstract

backgroundCompared to women with a live birth, women with a stillbirth are more likely to have maternal complications during pregnancy and at birth, but risk factors related to their postpartum health are uncertain.

objectiveThis study aimed to identify patient-level risk factors for postpartum hospital readmission among women after having a stillbirth. STUDY

designThis was a population-based cohort study of 29,654 women with a stillbirth in California from 1997 to 2011. Using logistic regression models, we examined the association of maternal patient-level factors with postpartum readmission among women after a stillbirth within 6 weeks of hospital discharge and between 6 weeks and 9 months after delivery.

resultsWithin 6 weeks after a stillbirth, 642 women (2.2%) had a postpartum readmission. Risk factors for postpartum readmission after a stillbirth were severe maternal morbidity excluding transfusion (adjusted odds ratio, 3.02; 95% confidence interval, 2.28-4.00), transfusion at delivery but no other indication of severe maternal morbidity (adjusted odds ratio, 1.95; 95% confidence interval, 1.35-2.81), gestational hypertension or preeclampsia (adjusted odds ratio, 1.93; 95% confidence interval, 1.54-2.42), prepregnancy hypertension (adjusted odds ratio, 1.80; 95% confidence interval, 1.36-2.37), diabetes mellitus (adjusted odds ratio, 1.78; 95% confidence interval, 1.33-2.37), antenatal hospitalization (adjusted odds ratio, 1.78; 95% confidence interval, 1.43-2.21), cesarean delivery (adjusted odds ratio, 1.73; 95% confidence interval, 1.43-2.21), long length of stay in the hospital after delivery (>2 days for vaginal delivery and >4 days for cesarean delivery) (adjusted odds ratio, 1.59; 95% confidence interval, 1.33-1.89), non-Hispanic black race and ethnicity (adjusted odds ratio, 1.38; 95% confidence interval, 1.08-1.76), and having less than a high school education (adjusted odds ratio, 1.35; 95% confidence interval, 1.02-1.80). From 6 weeks to 9 months, 1169 women (3.90%) had a postpartum readmission; significantly associated risk factors were largely similar to those for earlier readmission.

conclusionWomen with comorbidities, with birth-related complications, of non-Hispanic black race and ethnicity, or with less education had increased odds of postpartum readmission after having a stillbirth, highlighting the importance of continued care for these women after discharge from the hospital.

Indexed as

Patient ReadmissionStillbirthCohort StudiesFemaleHumansInfant, NewbornPostpartum PeriodPregnancyRisk Factorsfetal deathpostpartum carepostpartum readmissionpregnancysevere maternal morbiditystillbirth

Identifiers

PMID33705999
PMCPMC8527843
OpenAlexW3135824106

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.