Abstract WMP86: Infection During Delivery Hospitalization is Associated With Increased Risk of Readmission for Postpartum Stroke

Introduction: Postpartum stroke is a rare and unpredictable complication of pregnancy. Infections have been associated with an increased risk of stroke in young people. We hypothesized that infections diagnosed during delivery hospitalizations would be associated with an increased risk of postpartum readmission for stroke. Methods: We conducted a weighted analysis of the 2013 Healthcare Cost and Utilization Project National Readmissions Database to assess the relationship between infection during a delivery hospitalization and 30-day readmission for a stroke. Delivery hospitalization, stroke and infections, and comorbidities were identified using ICD-9 diagnosis codes. We created survey design logistic regression models to calculate crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between infections and 30-day readmission for stroke, adjusting for disease severity, length of delivery hospitalization, and age. Results: There were 3,512,350 delivery hospitalizations, with 79,656 subsequent readmissions, including 225 for stroke. Compared with all other women who delivered, women with infections during the delivery hospitalization had higher odds of readmission for postpartum stroke (adjusted OR 5.7, 95%CI 2.4-13.6). When compared to women who were readmitted for non-stroke reasons, women who were readmitted for stroke had higher odds of an infection during the delivery hospitalization (adjusted OR 3.5, 95%CI 1.9-6.5). The effect of infection on postpartum stroke risk was present in women both with and without hypertensive disorders of pregnancy (Table). Conclusion: Infections diagnosed during delivery hospitalizations were associated with an increased risk of readmission for postpartum stroke. Women who are diagnosed with infections during delivery admissions should be educated on signs and symptoms of stroke and when to seek emergency medical attention.