Acute pyelonephritis and associated complications during pregnancy in 2006 in US hospitals

Abstract

Objective: To describe the occurrence of hospitalization for acute pyelonephritis during pregnancy and associated complications in 2006 in USA. Methods: Cases were defined as those with ICD-9-CM codes corresponding to the infections of the genitourinary tract in pregnancy and pyelonephritis in the 2006 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). Additional analyses identified those cases also coupled with ICD-9-CM codes corresponding to obstetrical and medical complications. Calculations were weighted to produce national estimates and hospitalization rates were determined. Results: Twenty-eight thousand nine hundred and twenty-three hospitalizations for pyelonephritis in pregnancy were identified. Women aged 8–19 had the highest hospitalization rate (175.06/10 000 cases) compared to other age groupings. Hispanic patients had the highest hospitalization rate of the recorded ethnicities (100.93/10 000 cases). Diabetes was a concomitant diagnosis in 3.7% of patients. Of the pregnant patients hospitalized with pyelonephritis, 3.77% had threatened preterm labor, 1.95% was diagnosed with sepsis, 0.77% had acute respiratory failure, and several deaths also occurred. The mean length of hospital stay was 2.8 days. The estimated annual cost of hospitalization for pyelonephritis in pregnancy was $263 million. Conclusions: Hospitalization for pyelonephritis in pregnancy is associated with recognizable characteristics including age and diabetes. Serious medical complications and even mortality can occur.

Keywords::

• Antepartum complication
• antepartum hospitalization
• Nationwide Inpatient Sample
• pyelonephritis

Declaration of Interest: Departmental financial support was provided for this investigation. This study was presented as an abstract at the Society for Maternal-Fetal Medicine 30^th Annual Meeting, Chicago, IL, February 2010.