For a study, researchers sought to assess postpartum hospitalization length of stay (LOS) and hospital readmission rates in obstetric patients before (March 2017–February 2020; pre-pandemic) and during the coronavirus disease 2019 (COVID-19) pandemic (March 2020–February 2021). They performed a retrospective cohort analysis on obstetric patients who delivered between March 1, 2017, and February 28, 2021, at 20–44 weeks of gestation and were released within 7 days of delivery, utilizing Epic Systems’ Cosmos research platform. The primary objective was a short postpartum hospitalization length of stay (< 2 midnights for vaginal deliveries and < 3 midnights for cesarean births), and the secondary outcome was hospital readmission within 6 weeks of postpartum hospitalization discharge. Using standardized differences and Bayesian logistic mixed-effects models, researchers examined outcomes before and during the epidemic across all newborns and stratified by the method of delivery.
About 742,113 (74.6%) of the 994,268 obstetric patients in the research group delivered before the COVID-19 pandemic, whereas 252,155 (25.4%) delivered during the pandemic. The percentage of short postpartum hospitalizations increased in all births (28.7–44.5%), vaginal births (25.4–39.5%), and cesarean births (35.3–55.1%) during the COVID-19 pandemic, which was consistent with the adjusted analysis (all births: aOR 2.35, 99% credible interval 2.32–2.39; vaginal births: aOR 2.14, 99% credible interval 2.11–2.18; cesarean birth Despite the fact that short postpartum hospitalizations were more common during the COVID-19 pandemic, there was no difference in readmission in unadjusted (1.4% vs 1.6%, standardized difference=0.009) or adjusted (aOR 1.02, 99% credible interval 0.97–1.08) analyses for all births or when stratified by mode of delivery.
A brief postpartum hospitalization LOS was considerably higher for obstetric patients during the COVID-19 pandemic, with no difference in hospital readmissions within 6 weeks of postpartum inpatient release. The COVID-19 pandemic generated a natural experiment, indicating that shorter postpartum hospitalization may be feasible for individuals who self-identify or are identified by a health care expert as being appropriate for discharge.
