Protective effect of rooming-in on postpartum hemorrhage: A propensity score analysis

Abstract

Objective: This study investigates the effect of rooming-in on postpartum hemorrhage (PPH) and other adverse maternal postpartum outcomes. Methods: A retrospective study was performed on all healthy women with singleton term pregnancies at a tertiary medical center between 2013 and 2022. Women were categorized by choice of neonatal care: hospital nursery or rooming-in. Propensity score matching (2:1) was based on maternal age, body mass index, parity, prior cesarean deliveries, pregnancy length, epidural administration, perineal lacerations, and neonatal birthweight. Primary outcome was PPH or the need for postpartum blood transfusion. Secondary outcomes were postpartum fever, postpartum preeclampsia, duration of hospitalization, pain intensity, urinary retention, and breastfeeding. Results: Of 74 279 women, 16 201 met the inclusion criteria; 15 459 were analyzed (10 306 nursery care, 5153 rooming-in). Rooming-in was associated with a lower incidence of PPH (1.71% vs. 2.43%, odds ratio [OR] 0.7, 95% confidence interval [CI] 0.55–0.89, P = 0.004), postpartum blood transfusion (0.60% vs. 1.13%, OR 0.53, 95% CI 0.36–0.79, P = 0.001), postpartum hospitalization exceeding 48 h (82.42% vs. 86.81%, OR 0.71, 95% CI 0.65–0.78, P < 0.001) and 72 h (12.17% vs. 13.75%, OR 0.87, 95% CI 0.79–0.96, P = 0.006), and a higher rate of breastfeeding (92.66% vs. 85.79%, OR 3.35, 95% CI 2.83–3.97, P < 0.001). Conclusions: The physiological benefits of rooming-in might optimize maternal health outcomes and reduce the use of postpartum health care.