Determinants of puerperal sepsis among postpartum women: a case–control study in East Shoa Zone public hospitals, Central Ethiopia

Oyato, Befekadu Tesfaye; Debele, Tirunesh; Edosa, Dejene; Abasimel, Husen Zakir; Awol, Mukemil; Kebede, Eleni Tesfaye; Gezahagn, Andualem; Desta, Adugna Alemu; Alemu, Fikadu Tolesa; Asfaw, Samuel Boja

doi:10.1136/bmjopen-2023-083230

Cited by 3 publications

References 30 publications

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Prevalence and Factors Associated with Puerperal Sepsis among Postnatal Women at a Tertiary Referral Hospital in Western Uganda

Nabawanuka,

Asiimwe,

Irumba

et al. 2024

Preprint

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Background: Puerperal sepsis remains one of the leading causes of maternal mortality and morbidity in Uganda. Aim: To assess the prevalence and factors associated with puerperal sepsis among postpartum women at Fort portal Regional Referral Hospital located in western Uganda. Methods: A cross-sectional design was used in the study. We conducted a records review of the patient files of 180 postnatal mothers who were admitted at Fort Portal Regional Referral Hospital from 5 January 2024 to 01 February 2024. A data abstraction checklist was used to collect data from participant files based on strict inclusion and exclusion criteria. Data was entered in Microsoft Excel and exported to STATA17 for data analysis. Descriptive analysis and logistic regression analysis were performed to determine the prevalence of puerperal sepsis and determinants. Bivariate and multivariate logistic regression analysis was conducted for significant factors presented as Adjusted Odds Ratios (aOR) at p<=0.05. Results: The median age of participants was 25.5 years (1QR=20-30) and the majority (77%) had primary education. The prevalence of postnatal sepsis was 24%. Duration of hospital stay [aOR=2.30; 95%CI (1.552-3.398); p=<0.001], history of antepartum hemorrhage [aOR=29.09; 95% CI (1.182-716.38); p=0.039] and Anemia [aOR=0.01; 95% CI (0.001-0.218); p=0.004] were identified as factors associated with puerperal sepsis among postnatal women upon multivariate logistic regression. Conclusion: Puerperal sepsis was common in our setting. This study found that mode of delivery, duration of hospital stay, anemia, and Antepartum hemorrhage, were the determining factors contributing to puerperal sepsis, infection prevention measures during cesarean sections, and reducing the length of hospital stay would prove to be beneficial in the prevention of sepsis.

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Prevalence and Factors Associated with Puerperal Sepsis among Postnatal Women at a Tertiary Referral Hospital in Western Uganda

Nabawanuka,

Asiimwe,

Irumba

et al. 2024

Preprint

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Determinants of puerperal sepsis among mothers who give birth at Jigjiga public hospitals, Somali Regional State, Eastern Ethiopia

Ali,

Tahlil,

Mohamud

et al. 2024

Preprint

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Introduction: Puerperal sepsis is a significant public health concern in low-resource settings, including Ethiopia, where it is a major contributor to maternal mortality, accounting for 13% of maternal deaths. We investigated the determinants of puerperal sepsis among mothers who give birth at Jigjiga Public Hospitals, Somali Regional State, Eastern Ethiopia. Methods:A facility-based unmatched case-control design was employed, with a sample size of 227 (76 cases and 151 controls). The study was conducted at two public hospitals in Jigjiga, Eastern Ethiopia, from January 2022 to December 2022. Data was collected using a standardized structured questionnaire and medical record review. Data were analyzed using SPSS software version 26. Multivariate logistic regression analysis was used to identify the determinants of puerperal sepsis. The level of significance was set at 0.05. Results: The mean age of the mothers was 30.2±10.2 years for cases and 31.5±6.7 years for controls. The results showed that not attending antenatal care regularly (aOR: 3.2, 95% CI: 1.483-6.940), having fewer antenatal care follow-ups (aOR: 3.3, 95% CI: 1.608-6.589), membranes rupturing for less than 24 hours (aOR: 4.6, 95% CI: 1.933-11.028), and having fewer pelvic examinations (aOR: 12.1, 95% CI: 2.873-19.131) were determinants of puerperal sepsis. Conclusion: The study found that several factors were associated with puerperal sepsis, including irregular antenatal care attendance, fewer antenatal follow-ups, delayed membrane rupture, and fewer pelvic examinations. To address this issue, healthcare providers and policymakers should prioritize improving access to quality antenatal care, empowering mothers through education and enhancing maternal education, and implementing evidence-based guidelines for managing obstetric complications.

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A simple predictive model for puerperal infections: emphasizing risk factors and pathogen analysis

Wen,

Ming,

Yang

et al. 2024

Front. Cell. Infect. Microbiol.

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BackgroundPuerperal infection (PI) accounting for approximately 11% of maternal deaths globally is an important preventable cause of maternal morbidity and mortality. This study aims to analyze the high-risk factors and pathogenic bacteria of PI, design a nomogram to predict the risk of PI occurrence, and provide clinical guidance for prevention and treatment to improve maternal outcomes.MethodsA total of 525 pregnant women were included in the study. The mothers were randomly divided into a training cohort (n=367) and a test cohort (n=158). The performance of our model was assessed using the area under the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analyses. All the women in the group of PI underwent blood culture tests, if the bacteria were detected, drug sensitivity tests were performed. The drug sensitivity spectrum was recorded and analyzed.ResultsUnivariate analysis showed that 12 indicators were significantly different (P < 0.05). Logistic regression analysis showed 6 factors, such as parity, number of vaginal examinations, amount of postpartum bleeding, antibiotics administered in one week before admission, induced labor, and indwelling catheter were significantly different between the PI group and control group (P < 0.05). The area under the ROC curve was 0.904 (95% CI: 0.871-0.936) in the training set and 0.890 (95% CI: 0.837-0.942) in the test set. The calibration curve of the nomogram showed good agreement between prediction and observation. The analysis of the clinical decision curve showed that the nomogram is of practical significance. There were 100 patients with positive blood cultures in the PI group, and Escherichia.coli was the main pathogenic bacteria, accounting for 89%. The sensitivity to Meropenem and Imipenem was 100%, to Piperacillin tazobactam 97.75%, to Ceftazidime 95.51%, and to Amoxicillin/Clavulanat (AMC) was 93.26%.ConclusionThe risk of PI will be significantly reduced by controlling the number of vaginal examinations less than 4 times, postpartum hemorrhage less than 414ml, and reducing the time of urethral catheter indwelling. If PI was clinically diagnosed or highly suspected, it was recommended to use antibiotics that were sensitive to Escherichia. coli, such as Piperacillin tazobactam, Ceftazidime, and AMC

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Determinants of puerperal sepsis among postpartum women: a case–control study in East Shoa Zone public hospitals, Central Ethiopia

Cited by 3 publications

References 30 publications

Prevalence and Factors Associated with Puerperal Sepsis among Postnatal Women at a Tertiary Referral Hospital in Western Uganda

Prevalence and Factors Associated with Puerperal Sepsis among Postnatal Women at a Tertiary Referral Hospital in Western Uganda

Determinants of puerperal sepsis among mothers who give birth at Jigjiga public hospitals, Somali Regional State, Eastern Ethiopia

A simple predictive model for puerperal infections: emphasizing risk factors and pathogen analysis

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