{
  "abstract": "Introduction Maternal and newborn morbidity and mortality are a global concern. Understanding the epidemiology of post-discharge complications could identify opportunities for interventions. We aimed to quantify mortality, care-seeking events and readmission among mothers and newborns in Uganda following facility-based delivery.Methods This prospective observational study (Apr 2022-Sep 2023) enrolled women presenting for delivery at two regional referral hospitals in Uganda. Data were collected during admission and 6 weeks after delivery by phone.Results Overall, 7131 women delivered 7359 newborns, of whom 7129 (99%) women and 6968 (94%) newborns were discharged alive. The newborn mortality rate was 2.7% and 32% of deaths occurred post-discharge. Following discharge, 230 (3%) women and 287 (4%) newborns were readmitted. Suspected sepsis and infections were the most common reasons for readmission among mothers (62.2%) and newborns (89.9%). Caesarean delivery (OR:2·26 (1·75-2·93)) and perinatal death (OR:3·18 (2·09-4·69)) were associated with post-discharge maternal readmission. Both maternal and newborn readmission were associated with household food insecurity during pregnancy (maternal OR:1·56 (1·15-2·08); newborn OR: 1·73 (1·31-2·25)). Newborn resuscitation with oxygen was associated with maternal readmission (OR:2.24 (1.24–3·78)), newborn readmission (OR: 2·74 (1·54-4·56)) and newborn death (OR: 4·01 (1·73-8·21)). Although >99% of women had ≥1 antenatal care visit, only 511 (7%) had ≥1 routine postnatal care visit. There were no routine postnatal care visits among 211 (91·7%) readmitted mothers, 276 (96·2%) newborns and 57 (91·9%) newborns who died.Conclusion Post-discharge complications occur in a context of low routine postnatal care use. Risk-informed discharge planning, postnatal care and health education strategies may improve outcomes in mothers, newborns and their families.",
  "authors": [
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada",
        "The University of British Columbia Department of Anesthesiology Pharmacology & Therapeutics, Vancouver, British Columbia, Canada"
      ],
      "name": "Yashodani Pillay"
    },
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada"
      ],
      "name": "Vuong Nguyen"
    },
    {
      "affiliations": [
        "Walimu, Kampala, Uganda"
      ],
      "name": "Clare Komugisha"
    },
    {
      "affiliations": [
        "Department of Paediatrics, BC Children’s Hospital, The University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Pascal M Lavoie"
    },
    {
      "affiliations": [
        "Medical Practice Evaluation Centre, Centre for Global Health, Department of Medicine and Division of 22 Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Lisa M Bebell"
    },
    {
      "affiliations": [
        "Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Marianne Vidler"
    },
    {
      "affiliations": [
        "BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada"
      ],
      "name": "Beth A Payne"
    },
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada"
      ],
      "name": "Jessica Trawin"
    },
    {
      "affiliations": [
        "Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Astrid Christofferson-Deb"
    },
    {
      "affiliations": [
        "Walimu, Kampala, Uganda"
      ],
      "name": "Douglas Mwesigwa"
    },
    {
      "affiliations": [
        "Walimu, Kampala, Uganda"
      ],
      "name": "Happy Annet Twinomujuni"
    },
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada",
        "The University of British Columbia Department of Anesthesiology Pharmacology & Therapeutics, Vancouver, British Columbia, Canada"
      ],
      "name": "Stefanie K Novakowski"
    },
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada",
        "The University of British Columbia Department of Anesthesiology Pharmacology & Therapeutics, Vancouver, British Columbia, Canada"
      ],
      "name": "Dustin Dunsmuir"
    },
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada",
        "The University of British Columbia Department of Anesthesiology Pharmacology & Therapeutics, Vancouver, British Columbia, Canada"
      ],
      "name": "J. Mark Ansermino"
    },
    {
      "affiliations": [
        "Jinja Regional Referral Hospital, Jinja, Eastern Region, Uganda"
      ],
      "name": "Abner Tagoola"
    },
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada",
        "Department of Paediatrics, BC Children’s Hospital, The University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Niranjan Kissoon"
    },
    {
      "affiliations": [
        "Walimu, Kampala, Uganda"
      ],
      "name": "Nathan Kenya-Mugisha"
    },
    {
      "affiliations": [
        "Jinja Regional Referral Hospital, Jinja, Eastern Region, Uganda"
      ],
      "name": "Angella Namala"
    },
    {
      "affiliations": [
        "Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Joseph Ngonzi"
    },
    {
      "affiliations": [
        "Institute for Global Health, BC Children’s Hospital, Vancouver, British Columbia, Canada",
        "The University of British Columbia Department of Anesthesiology Pharmacology & Therapeutics, Vancouver, British Columbia, Canada",
        "Walimu, Kampala, Uganda"
      ],
      "name": "Matthew O Wiens"
    }
  ],
  "title": "Post-discharge mortality, readmission and care seeking among postpartum women and their newborns following facility-based delivery in Uganda: a prospective observational study",
  "uid": "fe434430-04b1-5c10-97a0-c21cf8fcbbd8"
}