This retrospective cohort study included hospitals in the Perspective database with >100 deliveries over 2 years. Using a composite measure of infection, we estimated and compared RAIR across hospitals using hierarchical generalized linear models. We then estimated the amount of variation in RAIR attributable to hospital features.
Of the 1,001,189 deliveries at 355 hospitals, 4.1 % were complicated by infection. Patients aged 15-19 years were 50 % more likely to experience infection than those aged 25-29 years. Rupture of membranes >24 hours (odds ratio [OR], 3.0; 95 % confidence interval [CI], 3.24?3.5), unengaged fetal head (OR, 3.11; 95 % CI, 2.97?3.27), and blood loss anemia (OR, 2.42; 95 % CI, 2.34?2.49) had the highest OR among comorbidities commonly found in patients with infection. RAIR ranged from 1.0?14.4 % (median, 4.0 % ; interquartile range, 2.8?5.7 % ). Hospital features such as geographic region, teaching status, urban setting, and higher number of obstetric beds were associated with higher infection rates, accounting for 14.8 % of the variation observed.
Obstetric RAIR vary among hospitals, suggesting an opportunity to improve obstetric quality of care. Hospital features such as region, number of obstetric beds, and teaching status account for only a small portion of the observed variation in infection rates.