Epidemiology and Clinical Features of Maternal Sepsis：A Retrospective Study of Whole Pregnancy Period

Abstract

Background: Maternal sepsis results in poor outcomes such as fetal or maternal death. The incidence and mortality rates of maternal sepsis are variable in different places because of differences in economic development, race, medical conditions, etc. Identifying the clinical features and determining the possible mechanisms for avoiding morbidity and preventing poor outcomes would benefit committed patients. Therefore, this study was an epidemiological study at a maternity transfer centre in Southeast China that aimed to identify local disease features of maternal sepsis.Methods: This was a local epidemiological study in at a tertiary care center in Guangzhou, China, from 2015 to 2019. A total of 74969 pregnant women experiencing childbirth were included in this study; of these women, 74 patients with maternal sepsis were diagnosed by 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 experiment covers the whole period from first trimester to puerperium. The clinical data were collected via the hospital electronic medical record system. Single-factor regression and multivariate logistic regression were implemented to analyze the risk factors for maternal sepsis.Results: The incidence of maternal sepsis was 0.099%, the maternal mortality ratio was 0.004% and the fetal mortality ratio was 0.007%. For clinical manifestations, septic shock was associated with a higher severity of patient illness. All of the poor outcomes (maternal or fetal death) occurred during pregnancy. Postpartum sepsis had the longest onset period, and postpartum sepsis was associated with the premature rupture of fetal membranes and preeclampsia.Conclusions: Maternal sepsis is an important cause of both maternal and fetal mortality. Here we described an epidemiological study that evaluated the disease incidence, development and prognosis of local maternal sepsis. Furthermore, the characteristics of maternal sepsis is likely due to unknown pathological mechanisms, and patients would benefit from the identification of more effective treatments for maternal sepsis.