Epidemiology of and surveillance for postpartum infections

We screened automated ambulatory medical records, hospital and emergency ro om claims, and pharmacy records of 2,826 health maintenance organization (H MO) members who gave birth over a 30-month period. Full-text ambulatory rec ords were reviewed for the 30-day postpartum period to confirm infection st atus for a weighted sample of cases. The overall postpartum infection rate was 6.0%, with rates of 7.4% following cesarean section and 5.5% following vaginal delivery. Rehospitalization; cesarean delivery; antistaphylococcal antibiotics; diagnosis codes for mastitis, endometritis, and wound infectio n; and ambulatory blood or wound cultures were important predictors of infe ction. Use of automated information routinely collected by HMOs and insurer s allows efficient identification of postpartum infections not detected by conventional surveillance.