Factors related to postpartum length of stay in women with pre-eclampsia: a systematic review.

Abstract

<h4>Objective</h4>To conduct a systematic review in order to identify risk factors for the length of hospital stay in postpartum women with pregnancy-induced hypertensive disorders.<h4>Methods</h4>A systematic search was performed in the databases CINAHL, Cochrane Library, Embase, Latin American and Caribbean Health Sciences Literature (LILACS) (via VirtualHealth Library-VHL), PubMed, Scopus, and Web of Science for articles published until November 2024. To identify the articles, "Medical Subject Headings" (MeSH) descriptors and keywords for "Preeclampsia", "Length of stay" and "Postpartum" were used. The descriptors were adapted for each database and combined using Boolean operators (OR and AND). Cohort and case-control studies were included if: presented a population of patients with hypertensive disorders during pregnancy, addressed length of stay as an outcome and were published in English, Portuguese or Spanish.<h4>Results</h4>The initial search retrieved approximately 2,580 articles, eight of which met the inclusion criteria. The main risk factors for increased length of hospital stay were ascites (p < 0.001), cesarean delivery (p < 0.0001), drug-related problems (p = 0.0001), diastolic blood pressure above 100 mmHg (p = 0.006), intrauterine growth restriction (p = 0.0001), preeclampsia severity (p < 0.001), Congestive Heart Failure (p < 0.001) and Ventricular Tachycardia (p = 0.001). The included studies had a cohort design, with the general methodological quality considered good.<h4>Conclusions</h4>This review identified multiple factors influencing postpartum length of stay in women with preeclampsia, highlighting cesarean delivery and drug-related problems as key contributors. The findings underscore the importance of tailored interventions and local assessments to optimize hospital management and improve maternal outcomes.