Maternal Sepsis Mortality and Morbidity During Hospitalization for Delivery

Bauer, Melissa E.; Bateman, Brian T.; Bauer, Stephen M.; Shanks, Amy; Mhyre, Jill M.

doi:10.1213/ane.0b013e3182a009c3

Cited by 151 publications

(171 citation statements)

References 25 publications

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“…This study showed that medical comorbidities appear to have a strong association with adverse outcomes, which is consistent with the literature6, 11, 13, 14, 27, 31 and current management strategies. However, the particular medical conditions vary between studies.…”

Section: Discussionsupporting

confidence: 91%

“…Mode of delivery was found to be correlated with antenatal and postpartum sepsis (co‐efficient 0.6629), which was consistent with the literature 6, 11. This is most likely to be a result of antenatal sepsis leading to expedited delivery, particularly by caesarean section.…”

Section: Methodssupporting

confidence: 87%

“…These include studies of sepsis in obstetric populations,6, 9, 10, 11, 30 and other morbidities in obstetric populations 12, 13, 14, 27, 31, 32. Interestingly, all those studies found an effect of at least one socio‐demographic factor, most commonly age, body mass index (BMI) or ethnicity.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have compared women with severe sepsis to those with uncomplicated sepsis or normal pregnancies,6, 9, 10, 11 which will reflect factors that affect the incidence of sepsis, as well as progression of disease. However, no population‐based studies have compared sepsis‐related maternal deaths with morbidities, although this approach can highlight factors more pertinent to the most severe outcomes 12, 13, 14…”

Section: Introductionmentioning

confidence: 99%

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Progression from severe sepsis in pregnancy to death: a UK population‐based case‐control analysis

Mohamed-Ahmed

Nair

Acosta

et al. 2015

BJOG

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ObjectiveTo identify factors associated with progression from pregnancy‐associated severe sepsis to death in the UK.DesignA population‐based case‐control analysis using data from the UK Obstetric Surveillance System (UKOSS) and the UK Confidential Enquiry into Maternal Death (CEMD).SettingAll pregnancy care and death settings in UK hospitals.PopulationAll non‐influenza sepsis‐related maternal deaths (January 2009 to December 2012) were included as cases (n = 43), and all women who survived severe non‐influenza sepsis in pregnancy (June 2011 to May 2012) were included as controls (n = 358).MethodsCases and controls were identified using the CEMD and UKOSS. Multivariable logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals.Main outcome measuresOdds ratios for socio‐demographic, medical, obstetric and management factors in women who died from sepsis, compared with those who survived.ResultsFour factors were included in the final regression model. Women who died were more likely to have never received antibiotics [aOR = 22.7, 95% confidence interval (CI) 3.64–141.6], to have medical comorbidities (aOR = 2.53, 95%CI 1.23–5.23) and to be multiparous (aOR = 3.57, 95%CI 1.62–7.89). Anaemia (aOR = 13.5, 95%CI 3.17–57.6) and immunosuppression (aOR = 15.0, 95%CI 1.93–116.9) were the two most important factors driving the association between medical comorbidities and progression to death.ConclusionsThere must be continued vigilance for the risks of infection in pregnant women with medical comorbidities. Improved adherence to national guidelines, alongside prompt recognition and treatment with antibiotics, may reduce the burden from sepsis‐related maternal deaths.Tweetable abstractMedical comorbidities, multiparity and antibiotic delays increase the risk of death from maternal sepsis.

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Section: Discussionsupporting

confidence: 91%

Section: Methodssupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Progression from severe sepsis in pregnancy to death: a UK population‐based case‐control analysis

Mohamed-Ahmed

Nair

Acosta

et al. 2015

BJOG

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“…Aunque no está reportado en los resultados se observó un incremento en la mortalidad por sepsis en el periodo 2009 a 2012, el cual se explica posiblemente por la pandemia por H1N1 de 2009 (26), hecho que explica que la neumonía haya sido la primera causa de muerte por sepsis en nuestra serie de casos. Nuestros datos son consistentes con el último reporte de mortalidad materna en el Reino Unido, donde las muertes por influenza constituyeron el 43 % de los casos de sepsis en el periodo 2009-2012, hallazgo similar a lo reportado en Estados Unidos entre 1998 y 2008, cuando la influenza fue la causa del 29,7 % de las muertes maternas (27).…”

Section: Discussionunclassified

Estudio de mortalidad materna por sepsis en Antioquia, Colombia, entre los años 2004-2014: una mirada al desafío de la identificación y el tratamiento oportunos

Velásquez-Penagos

Vélez-Álvarez

Gómez-Dávila

et al. 2017

Rev. Colomb. Obstet. Ginecol.

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Objetivo: describir las características de las mujeres e identificar los factores de la atención que contribuyeron a las muertes maternas por sepsis en el departamento de Antioquia, Colombia.Materiales y métodos: serie de casos de las muertes maternas causadas por infección entre los años 2004 y 2014. Se analizaron las muertes maternas con base en las recomendaciones de la “Campaña para sobrevivir a la sepsis”, y en guías de práctica clínica de infecciones específicas. Los juicios se realizaron por consenso. Se evaluaron la oportunidad del diagnóstico de sepsis, el tratamiento antibiótico, el choque séptico, la toma de cultivos, la terminación del embarazo, la realización de la cirugía para control del foco infeccioso, el ingreso a unidad de cuidados intensivos, la remisión a un nivel de complejidad mayor y la calidad global del manejo. Análisis descriptivo.Resultados: de 476 muertes maternas, 47 (9,87 %) mujeres fallecieron por sepsis de origen no obstétrico y 11 (5,2 %) por infecciones propias del embarazo o puerperio. La neumonía fue la principal causa de muerte. Los principales factores que influyeron en el desenlace fueron las demoras en identificar el síndrome, en iniciar los antibióticos, asumir el manejo en niveles con baja capacidad resolutiva, tratamiento inadecuado del choque séptico y la falta de modificación de las conductas terapéuticas ante el deterioro de las pacientes.Conclusión: las muertes maternas por sepsis estuvieron principalmente asociadas a causas no obstétricas; hay factores críticos tales como el retraso en la identificación del síndrome, y el inicio oportuno y adecuado de los antibióticos que son susceptibles de intervención.

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Perinatal Outcomes Among Patients With Sepsis During Pregnancy

et al. 2021

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IMPORTANCE Rates of maternal sepsis are increasing, and prior studies of maternal sepsis have focused on immediate maternal morbidity and mortality associated with sepsis during delivery admission. There are no data on pregnancy outcomes among individuals who recover from their infections prior to delivery. OBJECTIVE To describe perinatal outcomes among patients with antepartum sepsis who did not deliver during their infection hospitalization.

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Maternal Sepsis Mortality and Morbidity During Hospitalization for Delivery

Cited by 151 publications

References 25 publications

Progression from severe sepsis in pregnancy to death: a UK population‐based case‐control analysis

Progression from severe sepsis in pregnancy to death: a UK population‐based case‐control analysis

Estudio de mortalidad materna por sepsis en Antioquia, Colombia, entre los años 2004-2014: una mirada al desafío de la identificación y el tratamiento oportunos

Perinatal Outcomes Among Patients With Sepsis During Pregnancy

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