Consequences of the COVID-19 pandemic on the postpartum course: Lessons learnt from a large-scale comparative study in a teaching hospital.

Kugelman, Nir; Toledano-Hacohen, Mirit; Karmakar, Debjyoti; Segev, Yakir; Shalabna, Eiman; Damti, Amit; Kedar, Reuven; Zilberlicht, Ariel

OBJECTIVE To evaluate the consequences of COVID-19 pandemic restrictions on the postpartum course. METHODS A retrospective cross-sectional study compared women who gave birth between March and April 2020 (first wave), between July to September 2020 (second wave), and a matched historical cohort throughout 2017-2019 (groups A, B, and C, respectively). Primary outcomes were postpartum length of stay (LOS), presentations to the emergency department (ED), and readmissions 30 days or longer after discharge. Following Bonferroni correction, P<0.016 was considered statistically significant. RESULTS In total, 3377 women were included: 640, 914, and 1823 in groups A, B, and C, respectively. LOS after birth (both vaginal and cesarean) was shorter in groups A and B compared to the control group (2.28±1.01 and 2.25±0.93 vs 2.55±1.10 days, P<0.001). Rates of ED presentations 30 days after discharge were higher in groups C and B compared to group A (6.63% and 6.45% vs 3.12%, P=0.006). Rates of readmissions 30 days after discharge were 0.78%, 1.42%, and 1.09% (groups A, B, and C, respectively), demonstrating no statistical difference (P=0.408). CONCLUSION During the COVID-19 pandemic, there was a reduction or no change in rates of ED presentations and readmissions, despite the shortened LOS after delivery. A shift in policy regarding the postpartum LOS could be considered.