Postpartum infections: occurrence, healthcare contacts and association with breastfeeding

Abstract

Objective: To investigate the following: (i) the occurrence of postpartum infections; (ii) the frequency of contact with either a general practitioner or a hospital due to postpartum infections; and (iii) the association of postpartum infections with continuation of breastfeeding.

Design: Cross-sectional study.

Setting: Department of Gynecology and Obstetrics Horsens Hospital, Horsens, Denmark.

Population: A total of 1871 women who gave birth at a regional hospital in Denmark over a one-year period (2007-2008).

Methods: Data were collected by a questionnaire given to the women and combined with data from general practitioner and hospital records.

Main outcome measures: The distribution of different infections, as well as the overall occurrence of any infection, was evaluated according to mode of delivery and breastfeeding status (stopped/continued).

Results: Within four weeks after delivery, 24% of all women had experienced one or more self-reported episode of infection. Breast infections (12%) were most frequent, followed by wound (3%), airway (3%), vaginal (3%) and urinary tract infections (3%), endometritis (2%) and "other infections" (2%). Of the women with an infection, 66% (265 of 395) contacted their general practitioner, while 9% (37 of 395) had contact with a hospital. A significantly larger proportion of women with a postpartum infection stopped breastfeeding (21%) within the first four weeks after delivery compared with women without infection (12%; p < 0.001).

Conclusions: Postpartum infections were common, and the occurrence is likely to be underestimated if based on hospital medical records only. Infection was associated with higher rates of discontinuation of breastfeeding.