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Clinical Obstetrics

Poster Session 4

(1027) The Effect of Rooming-in on Postpartum Hemorrhage: A Propensity Score Analysis

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: We aimed to investigate the effect of rooming-in on postpartum hemorrhage (PPH) and other immediate post-partum complications.

Study Design: Retrospective study conducted at a high-volume tertiary obstetric center. All healthy women with a singleton uncomplicated pregnancy and childbirth, between 2012 and 2022 were included. Women were categorized into 2 groups based on their choice of neonatal care method: rooming-in vs. hospital nursery. Propensity score matching was used to create comparable groups in a 2:1 ratio. The matching was based on the following parameters: age, body mass index (BMI) at birth, total pregnancy days, newborn weight, parity, prior cesarean section, epidural and perineal lacerations. The primary outcome measure was defined as PPH or the need for postpartum blood transfusion. Secondary outcomes included breastfeeding, postpartum fever, postpartum preeclampsia, and duration of hospitalization.

Results: A total of 79,936 women delivered during the study period, of which 16,201 met the inclusion criteria. After propensity score matching, 15,459 women were included in the analysis, of whom 10,306 chose nursery care and 5,153 rooming-in. Rooming-in was associated with lower odds of PPH (1.71% Vs. 2.43%, OR 0.7, 95% CI 0.55-0.89, p= 0.004), postpartum blood transfusion (0.60% Vs. 1.13%, OR 0.51, 95% CI 0.36-0.79, p=0.001) and a lower likelihood of postpartum hospitalization exceeding 48 hours (82.42% Vs. 86.81%, OR 0.71, 95% CI 0.65-0.78, p< 0.001) and 72 hours (12.17% Vs. 13.75%, OR 0.87, 95% CI 0.79-0.96, p=0.006). Rooming-in was also associated with a higher rate of breastfeeding (92.66% Vs. 85.79%, OR 2.09, 95% CI 1.86-2.36, p< 0.001). Choice of immediate neonatal care was not associated with postpartum fever or preeclampsia.

Conclusion:

This study provides evidence of an association between rooming-in and a decreased risk of PPH and the need for blood transfusion.

These findings highlight the potential benefits of the rooming-in practice and can assist in making more informed decisions regarding postpartum care.