Table 3.
Risk factors associated with peripartum hysterectomy performed on birth hospitalization versus readmission, Washington State, 1987-2006
| Risk factors | Controls (N = 3584) |
Birth Hospitalization Cases (N = 756) |
Readmission Cases (N = 111) |
||||
|---|---|---|---|---|---|---|---|
| n (%) | n (%) | OR (95% CI) § | n (%) | OR (95% CI) § | |||
| Hemorrhage related factors¥ | |||||||
| Placenta abnormalities | |||||||
| Placenta previa | 23 (0.6) | 191 (25.3) | 9.2 | (4.7 – 17.9) | 1 (0.9) | -- | -- |
| Abruptio placenta | 55 (1.5) | 67 (8.9) | 3.5 | (1.9 – 6.4) | 4 (3.6) | 1.1 | (0.2 – 5.8) |
| Retained placenta | 28 (0.8) | 206 (27.3) | 49.0 | (20.7 – 116.2) | 8 (7.2) | 18.9 | (4.2 – 85.2) |
| Atony of uterus | 111 (3.1) | 242 (32.0) | 33.1 | (20.0 – 54.9) | 11 (9.9) | 2.8 | (1.3 – 5.9) |
| Uterine rupture | 1 (0.0) | 75 (9.9) | 193.8 | (11.9 – 3149) | 2 (1.8) | 40.5 | (0.6 – 2867) |
| Thrombocytopenia | 18 (0.5) | 13 (1.7) | 6.0 | (1.8 – 20.0) | 0 (0.0) | -- | -- |
| Other hemorrhage related factors‡ | 8 (0.2) | 114 (15.1) | 182.2 | (35.5 – 934.4) | 72 (64.9) | 1041 | (34.8 – 3115) |
| Delivery method | |||||||
| Vaginal | 2739 (76.5) | 199 (26.5) | 1 | 71 (64.0) | 1 | ||
| Vaginal birth after cesarean | 105 (2.9) | 22 (2.9) | 1.9 | (1.2 – 3.1) | 5 (4.5) | 1.7 | (0.6 – 4.9) |
| Primary cesarean | 504 (14.1) | 253 (33.6) | 5.8 | (4.4 – 7.7) | 17 (15.3) | 1.2 | (0.6 – 2.4) |
| Repeat cesarean | 231 (6.5) | 278 (37.0) | 10.4 | (7.4 – 14.7) | 18 (16.2) | 1.9 | (1.0 – 3.6) |
| Instrumentation (only vaginal) | |||||||
| Spontaneous | 2249 (83.5) | 149 (77.6) | 1 | 55 (77.5) | 1 | ||
| Vacuum | 311 (11.6) | 30 (15.6) | 1.7 | (1.0 – 2.7) | 9 (12.7) | 1.9 | (0.8 – 4.7) |
| Forceps | 132 (4.9) | 13 (6.8) | 1.4 | (0.6 – 3.3) | 7 (9.9) | 2.8 | (0.8 – 10.0) |
| Multiple gestations¥ | 99 (2.8) | 59 (7.8) | 0.8 | (0.4 – 1.4) | 4 (3.6) | 1.2 | (0.4 – 4.5) |
| Infection related factors¥ | |||||||
| Chorioamnionitis | 66 (1.8) | 37 (4.9) | 4.7 | (2.2 – 10.0) | 2 (1.8) | 0.7 | (0.1 – 8.5) |
| Other infection related factors† | 106 (3.0) | 76 (9.7) | 2.5 | (1.5 – 4.1) | 33 (29.7) | 20.8 | (8.6 – 50.2) |
| Other¥ | |||||||
| Birth weight | |||||||
| 2500 – 3999 grams | 2868 (80.2) | 459 (61.7) | 1 | 94 (84.7) | 1 | ||
| < 2500 grams | 208 (5.8) | 172 (23.1) | 1.1 | (0.7 – 2.0) | 8 (7.2) | 0.9 | (0.3 – 3.0) |
| ≥ 4000 grams | 499 (14.0) | 113 (15.2) | 1.7 | (1.3 – 2.3) | 9 (8.1) | 0.5 | (0.3- 1.2) |
| Gestational diabetes | 158 (4.4) | 66 (8.7) | 1.5 | (1.0 – 2.4) | 4 (3.6) | 0.4 | (0.1 – 1.7) |
| Preeclampsia | 269 (7.5) | 81 (10.7) | 1.4 | (0.9 – 2.0) | 6 (5.4) | 1.6 | (0.6 – 4.1) |
§
Adjusted for maternal age, number of previous births, gestational age, and birth year.
¥
Adjusted for the previous variables and delivery method.
‡
Includes vasa previa and coagulation defects.
†
Includes endometritis, major puerperal infection, infection of genitourinary tract in pregnancy, puerperal fever, and sepsis.