Epidemiology and clinical features of maternal sepsis: A retrospective study of whole pregnancy period

Abstract

Maternal sepsis results in poor outcomes such as fetal or maternal death. The incidence and mortality rates of maternal sepsis vary in different places because of differences in economic development, race and medical conditions. Identifying the clinical features and determining possible mechanisms for avoiding morbidity and preventing poor outcomes would benefit committed patients. Therefore, this was an epidemiological study at a maternity transfer center in Southeast China that aimed to identify local disease features of maternal sepsis. To investigate the incidence and risk factors associated with maternal sepsis and its progression to severe sepsis in a large population-based birth cohort. This local epidemiological study was conducted in at a tertiary care center in Guangzhou, China, from 2015 to 2019. A total of 74,969 pregnant women experiencing childbirth were included in this study; Of these, 74 patients with maternal sepsis were diagnosed according to the sepsis criterion, and 118 patients without sepsis in the same period were selected randomly as the control group to study possible reasons for postpartum sepsis. This retrospective analysis covered the entire period from the first trimester to puerperium. Clinical data were collected using the hospital's electronic medical record system. Multivariate logistic regression was used to analyze risk factors for maternal sepsis. The incidences of maternal sepsis, the maternal mortality, and the fetal mortality were 0.099%, 0.004%, and 0.007%, respectively. Septic shock was associated with a higher severity of illness. All poor outcomes (maternal or fetal death) occurred during pregnancy. Postpartum sepsis had the longest onset period, and was associated with premature rupture of fetal membranes and preeclampsia. Sepsis is an important cause of both maternal and fetal mortality. Herein, we describe an epidemiological study that evaluated the incidence, development, and prognosis of local maternal sepsis. Furthermore, the characteristics of maternal sepsis are likely due to unknown pathological mechanisms, and patients would benefit from identifying more effective treatments for maternal sepsis.Abbreviations: APACHE II = acute physiology and chronic health evaluation II, BMI = body mass index, ICU = intensive care unit, IVF = in vitro fertilization, MSCs = mesenchymal stem cells, omSOFA = obstetrically modified SOFA failure assessment, PROM = premature rupture of membrane.

Neutrophil CD64 index as a good biomarker for early diagnosis of bacterial infection in pregnant women during the flu season

“…Pregnant women are at high risk of contracting influenza or bacterial infection during the flu season. Once infection occurs, it is easy for pregnant women to trigger a systemic inflammatory response 1,3,19,20 . The use of peripheral blood biomarkers for early diagnosis of infection in pregnant women is essential.…”

“…Once infection occurs, it is easy for pregnant women to trigger a systemic inflammatory response. 1 , 3 , 19 , 20 The use of peripheral blood biomarkers for early diagnosis of infection in pregnant women is essential. Pregnant women are a unique population and are less studied in this area.…”

Evaluation of microbiological epidemiology and clinical characteristics of maternal bloodstream infection: a 10 years retrospective study

“…Bloodstream infection in pregnancy or during the perinatal period is still a significant clinical problem with high morbidity and mortality, even in developed countries ( Waterstone et al, 2001 ; Surgers et al, 2013 ; Zou et al, 2021 ). There are some studies focusing on maternal infectious diseases in mainland China ( Lin et al, 2021 ; Zou et al, 2021 ; Zhong et al, 2022 ) but only one published study focused on perinatal BSI could be found ( Zou et al, 2021 ). Very little is known about various aspects of maternal bacteremia in relation to changes of microbiological epidemiology and obstetric outcomes.…”

Factors Associated with Increased Risk of Urosepsis during Pregnancy and Treatment Outcomes, in a Urology Clinic

“…Sepsis is a major cause of morbidity and mortality during pregnancy, both for the pregnant woman and the fetus [1]. Within the existing literature, the majority of studies have taken a broad approach, encompassing all causes of sepsis in pregnant women [2][3][4][5], and very few have specifically examined the impact of urinary tract infections (UTIs), particularly febrile infections, on the development of sepsis and its consequences for both mother and child. Similarly, factors associated with the occurrence of sepsis have been studied regardless of the site of primary infection [2,6,7].…”