为了评估与孕产妇脓毒症产后再入院相关的患病率、时间、临床危险因素和不良后果。我们使用以下方法对 15-54 岁患有和不患有脓毒症的女性进行了一项分娩住院治疗和产后 60 天再入院的回顾性队列研究。 2016-2020 年全国再入学数据库。使用美国国家癌症研究所的连接点回归计划分析了分娩住院期间和产后 60 天再入院期间脓毒症诊断的时间趋势，以估计 95% CI 的平均年百分比变化。 Logistic 回归模型适合确定分娩住院特征是否与产后脓毒症再入院相关，并报告了 95% CI 的未调整和调整比值比。描述了分娩住院和再入院期间与脓毒症相关的不良后果，包括死亡、严重发病、重症监护复合和肾衰竭。总体而言，在人口加权后纳入了 15,268,190 例分娩住院和 256,216 例相关的 60 天再入院，其中 16,399 例（ 1.1/1,000 名分娩住院患者）在分娩时被诊断为败血症，20,130 名患者（1.3/1,000 名分娩住院患者）在产后再次入院时被诊断为败血症。 7.9% 的产后再入院患者被诊断为脓毒症。与产后脓毒症再入院相关的特征包括分娩时年龄较小、医疗补助保险、邮政编码收入四分位中位数最低以及慢性疾病，例如肥胖、孕前糖尿病和慢性高血压。产后败血症再入院与分娩住院期间的感染有关，包括羊膜内感染或子宫内膜炎、伤口感染和分娩败血症。脓毒症诊断与 24.4% 的分娩时孕产妇死亡和 38.4% 的产后死亡相关，与 2.2% 的非输血严重发病病例（不包括分娩时脓毒症）和 13.6% 的产后死亡相关，与 15.6% 的分娩时重症监护综合诊断和 30.1% 的产后诊断相关，以及 11.1%分娩时和产后诊断出急性肾衰竭的比例为 36.4%。脓毒症在产后再入院中占很大比例，是分娩住院期间和产后再入院期间不良结果的主要原因。版权所有 © 2023 美国妇产科学院。由 Wolters Kluwer Health, Inc. 出版。保留所有权利。

To evaluate the prevalence, timing, clinical risk factors, and adverse outcomes associated with postpartum readmissions for maternal sepsis.We conducted a retrospective cohort study of delivery hospitalizations and 60-day postpartum readmissions for females aged 15-54 years with and without sepsis using the 2016-2020 Nationwide Readmissions Database. Temporal trends in sepsis diagnoses during delivery hospitalizations and 60-day postpartum readmissions were analyzed with the National Cancer Institute's Joinpoint Regression Program to estimate the average annual percent change with 95% CIs. Logistic regression models were fit to determine whether delivery hospitalization characteristics were associated with postpartum sepsis readmissions, and unadjusted and adjusted odds ratios with 95% CIs were reported. Adverse outcomes associated with sepsis during delivery hospitalization and readmission were described, including death, severe morbidity, a critical care composite, and renal failure.Overall, 15,268,190 delivery hospitalizations and 256,216 associated 60-day readmissions were included after population weighting, of which 16,399 (1.1/1,000 delivery hospitalizations) had an associated diagnosis of sepsis at delivery, and 20,130 (1.3/1,000 delivery hospitalizations) had an associated diagnosis of sepsis with postpartum readmission. A sepsis diagnosis was present in 7.9% of all postpartum readmissions. Characteristics associated with postpartum sepsis readmission included younger age at delivery, Medicaid insurance, lowest median ZIP code income quartile, and chronic medical conditions such as obesity, pregestational diabetes, and chronic hypertension. Postpartum sepsis readmissions were associated with infection during the delivery hospitalization, including intra-amniotic infection or endometritis, wound infection, and delivery sepsis. Sepsis diagnoses were associated with 24.4% of maternal deaths at delivery and 38.4% postpartum, 2.2% cases of nontransfusion severe morbidity excluding sepsis at delivery and 13.6% postpartum, 15.6% of critical care composite diagnoses at delivery and 30.1% postpartum, and 11.1% of acute renal failure diagnoses at delivery and 36.4% postpartum.Sepsis accounts for a significant proportion of postpartum readmissions and is a major contributor to adverse outcomes during delivery hospitalizations and postpartum readmissions.Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.