(HealthDay News) – Obstetric infection rates vary considerably between hospitals, according to a study published in the June issue of the American Journal of Obstetrics & Gynecology.
To examine the hospital-level risk-adjusted maternal infection rates (RAIRs), Sarah L. Goff, MD, from the Tufts University School of Medicine in Boston, and colleagues conducted a retrospective study including 1,001,189 deliveries at 355 hospitals participating in the Perspective database over two years. RAIRs were estimated using a composite measures of infection and compared across hospitals.
The researchers found that 4.1% of deliveries were complicated by infection. Infection was 50% more likely in patients aged 15–19 years compared to those aged 25–29 years. Among comorbidities commonly found in patients with infection, the highest odds were seen for rupture of membranes >24 hours (odds ratio [OR], 3.0), unengaged fetal head (OR, 3.11), and blood loss anemia (OR, 2.42). RAIR varied from 1.0–14.4% between hospitals (median, 4.0%). Hospital features that were linked to higher infection rates included geographic region, teaching status, urban setting, and higher number of obstetric beds, explaining 14.8% of the variation observed.
“In conclusion, we found that risk-adjusted infection rates following child- birth vary considerably across hospitals, and that key structural and organizational hospital features explain only a modest amount of this variation,” the authors write.