Postpartum maternal complications: a retrospective single-center study.

Abstract

Objectives: To evaluate the incidence and underlying causes of postpartum complications, with a focus on infections, among women who delivered at a tertiary maternity hospital over a 17-year period.

Methods: This retrospective observational study was conducted at the University Medical Center Ljubljana, the largest maternity hospital in Slovenia. The study included all women who delivered vaginally or via cesarean section between 2008 and 2024 and subsequently required medical assessment or hospitalization within six weeks postpartum. We analyzed the frequency and types of complications, paying special attention to infection rates by delivery method and microbiological findings from wound swabs.

Results: Postpartum complications were observed in 7.6 % of women following vaginal birth and 10.6 % after cesarean delivery. Infections and breastfeeding-related problems were the most common causes for medical reevaluation. After vaginal delivery, breast complications such as mastitis or milk stasis represented 36.4 % of all cases, followed by minor perineal issues. Following cesarean section, surgical site complications were most frequent (42.1 %), with a wound infection rate of 7.7 %. Between 2020 and 2024, readmissions to intensive care occurred in 0.92 % of vaginal deliveries and 2.76 % of cesarean deliveries. Endometritis was the most common infection after vaginal birth, while wound infections predominated post-cesarean. Wound swab cultures often revealed polymicrobial flora.

Conclusions: Postpartum infections remain a leading complication, particularly after cesarean delivery. Strengthening preventive measures including antibiotic prophylaxis, timely postpartum follow-up, and continuous microbial surveillance is critical to reducing maternal morbidity and supporting more effective, targeted interventions.