Table 1.
Demographics
| Mode of delivery | Vaginal delivery (no indication for antibiotics) | Vaginal delivery (indication for antibiotics) | Cesarean delivery | |||
|---|---|---|---|---|---|---|
| Antibiotics | Yes, n (%) | No, n (%) | Yes, n (%) | No, n (%) | Yes, n (%) | No, n (%) |
| All patients | 879,673 (100) | 1,992,613 (100) | 616,589 (100) | 148,507 (100) | 1,688,046 (100) | 211,328 (100) |
| Year | ||||||
| 2006 | 105,787 (12.0) | 172,072 (8.6) | 62,019 (10.1) | 11,841 (8.0) | 155,495 (9.2) | 22,678 (10.7) |
| 2007 | 104,834 (11.9) | 182,234 (9.1) | 60,921 (9.9) | 12,466 (8.4) | 163,159 (9.7) | 24,544 (11.6) |
| 2008 | 96,673 (11.0) | 180,403 (9.1) | 57,407 (9.3) | 13,207 (8.9) | 159,104 (9.4) | 25,037 (11.8) |
| 2009 | 92,890 (10.6) | 188,617 (9.5) | 61,205 (9.9) | 13,826 (9.3) | 169,167 (10.0) | 24,098 (11.4) |
| 2010 | 93,605 (10.6) | 201,307 (10.1) | 63,522 (10.3) | 15,461 (10.4) | 179,146 (10.6) | 20,708 (9.8) |
| 2011 | 99,554 (11.3) | 236,282 (11.9) | 72,764 (11.8) | 17,679 (11.9) | 201,293 (11.9) | 22,157 (10.5) |
| 2012 | 103,469 (11.8) | 261,376 (13.1) | 77,453 (12.6) | 19,373 (13.0) | 218,179 (12.9) | 23,275 (11.0) |
| 2013 | 94,029 (10.7) | 266,803 (13.4) | 75,805 (12.3) | 19,221 (12.9) | 213,573 (12.7) | 22,725 (10.8) |
| 2014 | 74,615 (8.5) | 250,699 (12.6) | 69,972 (11.3) | 20,636 (13.9) | 190,557 (11.3) | 21,603 (10.2) |
| 2015 1st quarter | 14,217 (1.6) | 52,820 (2.7) | 15,521 (2.5) | 4,797 (3.2) | 38,373 (2.3) | 4,503 (2.1) |
| Age in years | ||||||
| 18-24 | 337,823 (38.4) | 680,191 (34.1) | 224,451 (36.4) | 48,348 (32.6) | 446,020 (26.4) | 42,703 (20.2) |
| 25-34 | 438,116 (49.8) | 1065901 (53.5) | 316,761 (51.4) | 79,461 (53.5) | 918,304 (54.4) | 117,499 (55.6) |
| 35-39 | 85,977 (9.8) | 205,277 (10.3) | 62,357 (10.1) | 17,135 (11.5) | 255,131 (15.1) | 39,750 (18.8) |
| ≥ 40 | 17,757 (2.0) | 41,244 (2.1) | 13,020 (2.1) | 3,563 (2.4) | 68,591 (4.1) | 11,376 (5.4) |
| Marital Status | ||||||
| Married | 379,360 (43.1) | 990,647 (49.7) | 281,395 (45.6) | 72,572 (48.9) | 860,636 (51.0) | 113,180 (53.6) |
| Single | 365,090 (41.5) | 772,161 (38.8) | 263,511 (42.7) | 58,253 (39.2) | 624,851 (37.0) | 66,379 (31.4) |
| Other/Unknown | 135,223 (15.4) | 229,805 (11.5) | 71,683 (11.6) | 17,682 (11.9) | 202,559 (12.0) | 31,769 (15.0) |
| Race | ||||||
| White | 431,168 (49.0) | 1109579 (55.7) | 318,727 (51.7) | 75,926 (51.1) | 918,988 (54.4) | 103,590 (49.0) |
| Black | 145,181 (16.5) | 215,682 (10.8) | 112,594 (18.3) | 25,033 (16.9) | 252,002 (14.9) | 25,512 (12.1) |
| Other | 303,054 (34.5) | 666,101 (33.4) | 184,939 (30.0) | 47,447 (31.9) | 516,271 (30.6) | 82,171 (38.9) |
| Unknown | 270 (0.0) | 1,251 (0.1) | 329 (0.1) | 101 (0.1) | 785 (0.0) | 55 (0.0) |
| Payer | ||||||
| Medicare | 6,812 (0.8) | 12,603 (0.6) | 4,829 (0.8) | 1,101 (0.7) | 14,991 (0.9) | 1,725 (0.8) |
| Medicaid | 422,836 (48.1) | 854,928 (42.9) | 270,912 (43.9) | 61,830 (41.6) | 682,631 (40.4) | 70,492 (33.4) |
| Commercial | 393,623 (44.7) | 1003954 (50.4) | 307,290 (49.8) | 76,250 (51.3) | 898,895 (53.3) | 128,067 (60.6) |
| Uninsured | 27,325 (3.1) | 52,362 (2.6) | 13,206 (2.1) | 3,735 (2.5) | 36,618 (2.2) | 4,082 (1.9) |
| Unknown | 29,077 (3.3) | 68,766 (3.5) | 20,352 (3.3) | 5,591 (3.8) | 54,911 (3.3) | 6,962 (3.3) |
| Obstetric comorbidity index score | ||||||
| 0 | 828,891 (94.2) | 1900207 (95.4) | 576,130 (93.4) | 139,624 (94.0) | 1500045 (88.9) | 186,980 (88.5) |
| 1 | 30,196 (3.4) | 64,154 (3.2) | 27,111 (4.4) | 5,931 (4.0) | 92,219 (5.5) | 11,703 (5.5) |
| 2 | 15,706 (1.8) | 22,032 (1.1) | 10,356 (1.7) | 2,336 (1.6) | 70,180 (4.2) | 9,488 (4.5) |
| ≥2 | 4,880 (0.6) | 6,220 (0.3) | 2,992 (0.5) | 616 (0.4) | 25,602 (1.5) | 3,157 (1.5) |
| Rurality | ||||||
| Urban | 813,235 (92.4) | 1767226 (88.7) | 564,391 (91.5) | 132,415 (89.2) | 1525197 (90.4) | 196,495 (93.0) |
| Rural | 66,438 (7.6) | 225,387 (11.3) | 52,198 (8.5) | 16,092 (10.8) | 162,849 (9.6) | 14,833 (7.0) |
| Hospital Teaching | ||||||
| No | 536,708 (61.0) | 1221453 (61.3) | 350,028 (56.8) | 68,126 (45.9) | 1047706 (62.1) | 91,771 (43.4) |
| Yes | 342,965 (39.0) | 771,160 (38.7) | 266,561 (43.2) | 80,381 (54.1) | 640,340 (37.9) | 119,557 (56.6) |
| Hospital Bed Size | ||||||
| <400 | 475,768 (54.1) | 1152025 (57.8) | 332,438 (53.9) | 75,280 (50.7) | 944,292 (55.9) | 91,957 (43.5) |
| 400-600 | 220,864 (25.1) | 521,841 (26.2) | 168,792 (27.4) | 39,571 (26.6) | 421,484 (25.0) | 63,392 (30.0) |
| >600 | 183,041 (20.8) | 318,747 (16.0) | 115,359 (18.7) | 33,656 (22.7) | 322,270 (19.1) | 55,979 (26.5) |
| Region of Hospital | ||||||
| Northeastern | 112,071 (12.7) | 329,134 (16.5) | 94,827 (15.4) | 37,176 (25.0) | 224,769 (13.3) | 87,632 (41.5) |
| Midwest | 152,704 (17.4) | 377,857 (19.0) | 129,954 (21.1) | 16,392 (11.0) | 268,580 (15.9) | 20,166 (9.5) |
| South | 456,264 (51.9) | 809,635 (40.6) | 264,178 (42.8) | 63,968 (43.1) | 875,174 (51.8) | 62,782 (29.7) |
| West | 158,634 (18.0) | 475,987 (23.9) | 127,630 (20.7) | 30,971 (20.9) | 319,523 (18.9) | 40,748 (19.3) |
| PPH | 28,424 (3.2) | 41,910 (2.1) | 22,394 (3.6) | 4,147 (2.8) | 33,616 (2.0) | 3,419 (1.6) |
| Preeclampsia | 31,153 (3.5) | 47,046 (2.4) | 18,763 (3.0) | 3,900 (2.6) | 122,889 (7.3) | 14,635 (6.9) |
| Gestational diabetes | 40,334 (4.6) | 91,979 (4.6) | 32,265 (5.2) | 7,588 (5.1) | 136,306 (8.1) | 17,553 (8.3) |
| Diabetes | 4,964 (0.6) | 7,875 (0.4) | 4,335 (0.7) | 878 (0.6) | 30,984 (1.8) | 3,282 (1.6) |
| Multiple gestation | 8,113 (0.9) | 9,651 (0.5) | 5,392 (0.9) | 1,245 (0.8) | 71,781 (4.3) | 9,953 (4.7) |
PPH, postpartum hemorrhage. Patients were categorized based vaginal versus cesarean delivery, and if vaginal delivery occurred, whether there was an evidence-based diagnosis for administering antibiotics including preterm premature rupture of membranes, endometritis, chorioamnionitis, GBS colonization, and other infectious complications.