Rates vary from 1.0 to 14.4 percent; about 15 percent of variation due to hospital features
FRIDAY, July 26 (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, M.D., 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 percent of deliveries were complicated by infection. Infection was 50 percent more likely in patients aged 15 to 19 years compared to those aged 25 to 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 to 14.4 percent between hospitals (median, 4.0 percent). 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 percent 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.
Abstract (http://www.ajog.org/article/S0002-9378%2813%2900137-3/abstract )Full Text (http://www.ajog.org/article/S0002-9378%2813%2900137-3/fulltext )Editorial (http://www.ajog.org/article/S0002-9378(13)00249-4/fulltext )