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Maternal obesity, obstetric interventions and post-partum anaemia increase the risk of post-partum sepsis: a population-based cohort study based on Swedish medical health registers
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Ryhov County Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping. Ryhov County Hospital, Sweden.
2017 (English)In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 49, no 10, 765-771 p.Article in journal (Refereed) Published
Abstract [en]

Background: The objective was to estimate whether maternal obesity and/or obstetric interventions are associated with diagnosed maternal post-partum sepsis. Methods: A retrospective observational cohort study including all deliveries in Sweden between 1997 and 2012 (N=1,558,752). Cases of sepsis (n=376) were identified by International Classification of Diseases, (ICD-10) codes A40, A41 and O 85 in the Medical Birth Register and the National Patient Register. The reference population was non-infected, and therefore, women with any other infection diagnosis and/or with dispensed antibiotics within eight weeks post-partum were excluded. Information on dispensed drugs was available in the prescribed drug Register. Women with sepsis were compared with non-infected women concerning maternal characteristics and obstetric interventions. Adjusted odds ratios (aOR) were determined using the Mantel-Haenszel technique. Adjustments were made for maternal age, parity and smoking. Results: Obese women (body mass index 30) had a doubled risk of sepsis (3.6/10,000) compared with normal weight women (2.0/10,000) (aOR 1.85 (95%CI: 1.37-2.48)). Induction of labour (aOR 1.44 (95%CI: 1.09-1.91)), caesarean section overall (aOR 3.06 (95%CI: 2.49-3.77)) and elective caesarean section (aOR 2.41 (95%CI: 1.68-3.45)) increased the risk of sepsis compared with normal vaginal delivery. Post-partum anaemia due to acute blood loss was associated with maternal sepsis (aOR 3.40 (95%CI: 2.59-4.47)). Conclusions: Maternal obesity, obstetric interventions and post-partum anaemia due to acute blood loss increased the risk of diagnosed post-partum sepsis indicating that interventions in obstetric care should be considered carefully and anaemia should be treated if resources are available.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2017. Vol. 49, no 10, 765-771 p.
Keyword [en]
Post-partum; sepsis; obesity; caesarean section; anaemia
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-139831DOI: 10.1080/23744235.2017.1341055ISI: 000406138900006PubMedID: 28632072OAI: oai:DiVA.org:liu-139831DiVA: diva2:1133892
Note

Funding Agencies|Region Ostergotland

Available from: 2017-08-17 Created: 2017-08-17 Last updated: 2017-08-17

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Axelsson, DanielBlomberg, Marie
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Department of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesDivision of Children's and Women's healthDepartment of Gynaecology and Obstetrics in Linköping
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