(459) Risk Factors for Prolonged Hospitalization following vacuum-assisted delivery

We aimed to determine risk factors for prolonged hospitalization following vacuum-assisted delivery (VAD).

Study Design: A retrospective cohort study, in a single, university-affiliated tertiary medical center with approximately 12,500 deliveries annually (2012-2022) was conducted. Standard practice in our department entails a post-vaginal delivery hospital stay of 48 to 72 hours. Length of stay following a VAD was analyzed and parturients who underwent VAD were categorized into two groups by length of hospitalization (more and less than 7 days). Maternal and neonatal characteristics were compared. Risk factors for prolonged hospitalization were examined using univariate and multivariate logistic regression. 

Results:

(1) Overall, 133,035 deliveries occurred during the study period. Of them, 9,440 (7.1%) were by VAD.

(2) The post-partum hospitalization period was distributed as follows: 9134 (96.76%) women were hospitalized for up to 7 days, and 306 (3.34%) were hospitalized for more than 7 days.

(3) Using multivariate analysis: preterm delivery (delivery prior to 37 weeks) (RR 5.4 95%CI [1.6-17], p=0.005); preeclampsia (RR 6.0 95%CI [1.9-19], p=0.002), induction of labor (RR 3.4 95%CI [1.8;6.3], p< 0.001), obstetric anal sphincter injury (RR 3.2 95%CI [1.2-8], p=0.013), postpartum hemorrhage which required blood transfusion (RR 3.3 95%CI [1.3-8.4], p=0.012), and Apgar Score under 7 at minute 5 (RR 3.4 95%CI [1.4-39], p=0.015), were identified as independent risk factors for prolonged hospitalization [Table]

Conclusion: Risk factors associated with prolonged hospitalization following a VAD can be identified, with preterm delivery and Apgar score < 7 at minute 5 being the most prominent.