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BACKGROUND: Maternal sepsis is a major cause of gestational morbidity and neonatal mortality worldwide and particularly in China. AIM: To evaluate the etiology of maternal sepsis and further identify its risk factors. METHODS: In this retrospective study, we evaluated 70698 obstetric patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University between January 1, 2009 and June 30, 2018. Subjects were divided into sepsis group and non-sepsis group based on the incidence of sepsis. Data about medical history (surgical and obstetric history) and demographic information were collected. The Mann-Whitney U test was used to compare patient age, gestational age and duration of hospitalization between the two groups. Univariate and multivariate logistic regression models were used to analyze the etiology and the risk factors for maternal sepsis. Unadjusted and adjusted odds ratios (OR) are reported. RESULTS: A total of 561 of 70698 obstetric patients were diagnosed with infection; of the infected patients, 492 had non-sepsis associated infection (87.7%), while 69 had sepsis (12.3%). The morbidity rate of maternal sepsis was 9.76/10000; the fatality rate in the sepsis group was 11.6% (8/69). Emergency admission (OR = 2.183) or transfer (OR = 2.870), irregular prenatal care (OR = 2.953), labor induction (OR = 4.665), cervical cerclage (OR = 14.214), first trimester (OR = 6.806) and second trimester (OR = 2.09) were significant risk factors for maternal sepsis. CONCLUSION: Mode of admission, poor prenatal care, labor induction, cervical cerclage, first trimester and second trimester pregnancy were risk factors for maternal sepsis. Escherichia coli was the most common causative organism for maternal sepsis, and the uterus was the most common site of infection.
RESUMEN
The aim of this study was to identify risk factors among obstetric patients admitted to the intensive care unit (ICU).The study was conducted in Third Affiliated Hospital of Guangzhou Medical University during January 1, 2009 and December 31, 2016. A total of 44,817 pregnant women ≥20 weeks of gestational age were scanned. Demographic characteristics, perinatal outcomes, and risk factors among participants were analyzed.A number of factors (21) were more prevalent in the ICU admission group. The greatest for admission to the ICU occurred with amniotic fluid embolism, heart disease, acute fatty liver, and referral for care. The incidence of postpartum hemorrhage, hysterectomy, organ failure, and method of delivery differed significantly between groups (Pâ<â.05). Adverse neonatal outcome differed significantly between groups (Pâ<â.05).Complications of pregnancy are risk factors for referral to the ICU and may increase risk for unexpected outcomes among mothers and neonates.