Postpartum infections: occurrence, healthcare contacts and association with breastfeeding

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 (20072008). 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.