Postpartum Hospital Readmissions Among Women With Gestational Diabetes and Pregestational Diabetes in the United States, 2016 to 2022

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OBJECTIVE: We estimated postpartum hospital readmissions trends among women with gestational diabetes mellitus (GDM), pregestational diabetes mellitus (PDM; i.e., diabetes present before pregnancy), and neither. METHODS: Using the National Readmissions Database, we identified women aged 15-44 years who had a live birth or stillbirth between January 1 and June 30 annually, from 2016 through 2022. Births by diabetes status (GDM, PDM, and no diabetes diagnosis) were grouped to obtain the 1) rates of postpartum rehospitalization for all causes, severe maternal morbidity (SMM), diabetes-related diagnoses, and mental health-related diagnoses, 2) repeated admissions, and 3) the leading causes of readmission. Joinpoint regression was used to assess trends in outcomes for 30, 60, and 180 days postpartum. RESULTS: From 2016 to 2022, rates of all-cause postpartum readmissions increased significantly among women with GDM and women without diabetes by 30 days (annual percent change [APC], 2.78 for both), whereas rates of SMM postpartum readmissions decreased significantly among women with GDM by 30 days (APC, -7.44), 60 days (APC, -7.12), and 180 days (APC, -6.37), among women with PDM by 60 days (APC, -7.05), and among women with no diabetes by 30 days (APC, -5.83), 60 days (APC, -5.68), and 180 days (APC, -4.45). Postpartum diabetes-related readmission rates decreased for all periods among women with GDM and without diabetes (APC p values < .05) and by 180 days among women with PDM (APC, -7.03). Repeated diabetes-related admissions decreased at 60 and 180 days postpartum (APC p values < .05) among women with PDM. Hypertensive disorders were among the top three reasons for readmissions, regardless of diabetes status. CONCLUSION: Although all-cause readmissions increased by 30 days among women with GDM and without diabetes, postpartum SMM and diabetes-related readmissions decreased overall among women with GDM, PDM, and neither. Hypertensive disorders as a top reason for readmission suggests the need to monitor these disorders among women with GDM and PDM at birth.

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