{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T13:22:01Z","timestamp":1771939321204,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: Postpartum maternal readmission is a significant burden for patients as well as the health system. Postpartum readmission rate is a known factor in evaluating quality of care and in guiding potential beneficial interventions. Use of the Robson Group (RG) classification, initially used for analysis of cesarean section (CS) rates, has been recently expanded to evaluate other obstetrical outcomes. We aimed to describe the rates of postpartum maternal readmission across RG classification and to identify risk factors among the different maternity groups. Study Design: We carried out a retrospective register-based cohort study of all women who delivered &gt;24 weeks gestation at a tertiary medical center over an 18-year period, with classification into the 10 RGs. Rates of postpartum readmission within 42 days of delivery were calculated for each group, as well as indications for readmission. The risk for maternal readmission was analyzed by univariate binary logistic regressions with comparison of results among RC groups, as well as by multivariate analysis models. Results: During the study period, 296,768 deliveries were classified according to Robson Group (RG) classification. The overall readmission rate for the study population was 0.5%. The following groups had a significant risk of readmission: RG 9 (transverse lie), 1.9%; RG 8 (multifetal pregnancies), 1.90=3%; RG 7 (multiparous breech pregnancies) 1.2% and RG2 (nulliparous pregnancies &gt; 37 w, labor induction or prelabor cesarean), 1.2%. The most common indication for readmission among all RGs was fever (61.4%). Conclusions: Postpartum readmission rates varied among the RGs. The highest-risk groups were those with a higher risk of operative delivery, prolonged labor, or malpresentations. Interventions aimed to reduce the number of women in these groups; these included use of external cephalic version, vaginal delivery of breech, and multifetal pregnancies, all of which may be beneficial.<\/jats:p>","DOI":"10.3390\/jcm15051697","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:19:23Z","timestamp":1771935563000},"page":"1697","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Postpartum Readmission Rates and Associated Risk Factors Using the Robson Classification: A Single-Center Experience"],"prefix":"10.3390","volume":"15","author":[{"given":"Zvi","family":"Ehrlich","sequence":"first","affiliation":[{"name":"Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5377-7782","authenticated-orcid":false,"given":"Tzuria","family":"Peled","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rivka","family":"Farkash","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorina","family":"Grisaru-Granovsky","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel"},{"name":"Faculty of Medicine, Hebrew University of Jerusalem, P.O. Box 12272, Jerusalem 9112001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunit","family":"Armon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel"},{"name":"Faculty of Medicine, Hebrew University of Jerusalem, P.O. Box 12272, Jerusalem 9112001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"113.e1","DOI":"10.1016\/j.ajog.2016.01.174","article-title":"A multi-state analysis of postpartum readmissions in the United States","volume":"215","author":"Clapp","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1056\/NEJMsa1513024","article-title":"Readmissions, Observation, and the Hospital Readmissions Reduction Program","volume":"374","author":"Zuckerman","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"123S","DOI":"10.1097\/01.AOG.0000533520.08596.85","article-title":"Postpartum Readmissions: What We Can Learn From Numbers? [18K]","volume":"131","author":"Nasab","year":"2018","journal-title":"Obstet. Gynecol."},{"key":"ref_4","first-page":"B2","article-title":"Society for Maternal-Fetal Medicine Special Statement: A critique of postpartum readmission rate as a quality metric","volume":"226","author":"Combs","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/1471-0528.13526","article-title":"WHO statement on caesarean section rates","volume":"123","author":"Betran","year":"2016","journal-title":"BJOG"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1053\/beog.2000.0156","article-title":"Can we reduce the caesarean section rate?","volume":"15","author":"Robson","year":"2001","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1111\/aogs.14350","article-title":"A step towards better audit: The Robson Ten Group classification system for outcomes other than cesarean section","volume":"101","author":"Savchenko","year":"2022","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1111\/ajo.13169","article-title":"Use of the Robson Ten Group Classification System to categorise operative vaginal delivery","volume":"60","author":"Kane","year":"2020","journal-title":"Aust. New Zealand J. Obstet. Gynaecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ejogrb.2013.01.027","article-title":"The rate of obstetric anal sphincter injuries in Finnish obstetric units as a patient safety indicator","volume":"169","author":"Gissler","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1111\/1471-0528.16931","article-title":"Postpartum haemorrhage trends in Sweden using the Robson ten group classification system: A population-based cohort study","volume":"129","author":"Ladfors","year":"2022","journal-title":"BJOG"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100464","DOI":"10.1016\/j.xagr.2025.100464","article-title":"Association of Robson Ten Group Classification System with neonatal\/postneonatal mortality: An analysis for the effect of the mass migration","volume":"5","author":"YaparEyi","year":"2025","journal-title":"AJOG Glob. Rep."},{"key":"ref_12","unstructured":"Israel Central Bureau of Statistics (2021). Births and Fertility in Israel 2020, Publication No. 1926."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Symonds, N.E., Vidler, M., Wiens, M.O., Omar, S., English, L.L., Ukah, U.V., Ansermino, J.M., Ngonzi, J., Bebell, L.M., and Hwang, B. (2023). Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: A systematic review. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-05459-y"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1067\/mob.2002.125765","article-title":"Length of hospital stay, obstetric conditions at childbirth, and maternal readmission: A population-based cohort study","volume":"187","author":"Liu","year":"2002","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100317","DOI":"10.1016\/j.ajogmf.2021.100317","article-title":"Risk factors for postpartum readmission for preeclampsia or hypertension before delivery discharge among low-risk women: A case-control study","volume":"3","author":"Stamilio","year":"2021","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1038\/jp.2016.252","article-title":"The relationship between the rising cesarean delivery and postpartum readmission rates","volume":"37","author":"Clapp","year":"2017","journal-title":"J. Perinatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.jogc.2019.09.009","article-title":"Examining Cesarean Section Rates in Canada Using the Modified Robson Classification","volume":"42","author":"Gu","year":"2020","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/14767058.2019.1601697","article-title":"Postpartum hemorrhage and risk for postpartum readmission","volume":"34","author":"Fein","year":"2021","journal-title":"J. Matern. -Fetal Neonatal Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-024-06663-0","article-title":"Risk factors for postpartum readmission: A prediction model in Iranian pregnant women","volume":"24","author":"Firouzbakht","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2466210","DOI":"10.1080\/14767058.2025.2466210","article-title":"Clinical and demographic factors associated with increased risk of postpartum readmission among patients presenting to the emergency department by 6 weeks postpartum","volume":"38","author":"Murphy","year":"2025","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"100278","DOI":"10.1016\/j.xagr.2023.100278","article-title":"Postpartum readmission in Maryland by race and ethnicity, 2016\u20132019","volume":"3","author":"Hamilton","year":"2023","journal-title":"AJOG Glob. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100094","DOI":"10.1016\/j.xagr.2022.100094","article-title":"Early postpartum readmissions: Identifying risk factors at birth hospitalization","volume":"2","author":"Girsen","year":"2022","journal-title":"AJOG Glob. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e929283-1","DOI":"10.12659\/MSM.929283","article-title":"Risk factors and safety analyses for intrapartum fever in pregnant women receiving epidural analgesia during labor","volume":"27","author":"Ren","year":"2021","journal-title":"Med. Sci. Monit."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/aogs.15035","article-title":"Maternal postpartum infection risk following induction of labor: A Danish national cohort study","volume":"104","author":"Carlsen","year":"2025","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.jmwh.2008.01.007","article-title":"Postpregnancy Genital Tract and Wound Infections","volume":"53","author":"Tharpe","year":"2008","journal-title":"J. Midwifery Womens Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ejogrb.2022.04.026","article-title":"Prediction model for prolonged hospitalization following cesarean delivery","volume":"274","author":"Gabbai","year":"2022","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Seijmonsbergen-Schermers, A.E., van den Akker, T., Rydahl, E., Beeckman, K., Bogaerts, A., Binfa, L., Frith, L., Gross, M.M., Misselwitz, B., and H\u00e1lfd\u00e1nsd\u00f3ttir, B. (2020). Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. PLoS Med., 17.","DOI":"10.1371\/journal.pmed.1003103"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.tjog.2025.04.008","article-title":"Postpartum readmission associated with severe maternal morbidity: A systematic review","volume":"64","author":"Huang","year":"2025","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/AOG.0000000000005680","article-title":"Readmission Rates After Expedited Postpartum Discharge","volume":"144","author":"Walia","year":"2024","journal-title":"Obstet. Gynecol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1697\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:51:10Z","timestamp":1771937470000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15051697"],"URL":"https:\/\/doi.org\/10.3390\/jcm15051697","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]}}}