Format

Send to:

Choose Destination
See comment in PubMed Commons below
BJOG. 2012 Mar;119(4):474-83. doi: 10.1111/j.1471-0528.2011.03239.x. Epub 2012 Jan 18.

Maternal sepsis: a Scottish population-based case-control study.

Author information

  • 1National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK. colleen.acosta@npeu.ox.ac.uk

Abstract

OBJECTIVE:

To describe the risk of maternal sepsis associated with obesity and other understudied risk factors such as operative vaginal delivery.

DESIGN:

Population-based, case-control study.

SETTING:

North NHS region of Scotland.

POPULATION:

All cases of pregnant, intrapartum and postpartum women with International Classification of Disease-9 codes for sepsis or severe sepsis recorded in the Aberdeen Maternal and Neonatal Databank (AMND) from 1986 to 2009. Four controls per case selected from the AMND were frequency matched on year-of-delivery.

METHODS:

Cases and controls were compared; significant variables from univariable regression were adjusted in a multivariable logistic regression model.

MAIN OUTCOME MEASURES:

Dependent variables were uncomplicated sepsis or severe ('near-miss') sepsis. Independent variables were demographic, medical and clinical delivery characteristics. Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (95% CI) are reported.

RESULTS:

Controlling for mode of delivery and demographic and clinical factors, obese women had twice the odds of uncomplicated sepsis (OR 2.12; 95% CI 1.14-3.89) compared with women of normal weight. Age <25 years (OR 5.15; 95% CI 2.43-10.90) and operative vaginal delivery (OR 2.20; 95% CI 1.02-4.87) were also significant predictors of sepsis. Known risk factors for maternal sepsis were also significant in this study (OR for uncomplicated and severe sepsis respectively): multiparity (OR 6.29, 12.04), anaemia (OR 3.43, 18.49), labour induction (OR 3.92 severe only), caesarean section (OR 3.23, 13.35), and preterm birth (OR 2.46 uncomplicated only).

CONCLUSIONS:

Obesity, operative vaginal delivery and age <25 years are significant risk factors for sepsis and should be considered in clinical obstetric care.

© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

PMID:
22251396
[PubMed - indexed for MEDLINE]
PMCID:
PMC3328752
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley Icon for PubMed Central
    Loading ...
    Write to the Help Desk