Perinatal outcomes among births to women with infection during pregnancy

Baguiya Adama; Bonet Mercedes; Cecatti Jose Guilherme; Brizuela Vanessa; Curteanu Ala; Minkauskiene Meile; Jayaratne Kapila; Ribeiro-Do-Valle Carolina C.; Budianu Mihaela Alexandra; Souza Joao Paulo; Kouanda Seni

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BAGUIYA, Adama, BONET, Mercedes, CECATTI, Jose Guilherme, BRIZUELA, Vanessa, CURTEANU, Ala, MINKAUSKIENE, Meile, JAYARATNE, Kapila, RIBEIRO-DO-VALLE, Carolina C., BUDIANU, Mihaela Alexandra, SOUZA, Joao Paulo, KOUANDA, Seni. Perinatal outcomes among births to women with infection during pregnancy. In: Archives of disease in childhood, 2021, nr. 10(106), pp. 946-953. ISSN 0003-9888. DOI: https://doi.org/10.1136/archdischild-2021-321865

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Archives of disease in childhood

Numărul 10(106) / 2021 / ISSN 0003-9888 /ISSNe 1468-2044

Perinatal outcomes among births to women with infection during pregnancy

DOI:https://doi.org/10.1136/archdischild-2021-321865

Pag. 946-953

Baguiya Adama¹, Bonet Mercedes², Cecatti Jose Guilherme³, Brizuela Vanessa², Curteanu Ala⁴, Minkauskiene Meile⁵, Jayaratne Kapila⁶, Ribeiro-Do-Valle Carolina C.⁷, Budianu Mihaela Alexandra⁸, Souza Joao Paulo⁹, Kouanda Seni¹⁰

¹ Research Institute of Health Sciences, Ouagadougou,
² World Health Organization,
³ University of Campinas, Campinas,
⁴ Institute of Mother and Child,
⁵ Lithuanian University of Health Sciences, Kaunas,
⁶ Family Health Bureau, Colombo,
⁷ State University of Campinas – Unicamp,
⁸ George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures,
⁹ University of Sao Paulo, Sao Paulo,
¹⁰ Saint Thomas d'Aquin University (USTA), Ouagadougou

Disponibil în IBN: 25 octombrie 2021

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OBJECTIVE: This study is part of the Global Maternal Sepsis Study (GLOSS). It aimed to estimate neonatal near-miss (NNM) and perinatal death frequency and maternal risk factors among births to women with infection during pregnancy in low-income and middle-income countries (LMIC). DESIGN: We conducted a 1-week inception hospital-based cohort study. SETTING: The study was carried out in 408 hospitals in 43 LMIC of all the WHO regions in 2017. PATIENTS: We included women with suspected or confirmed infection during pregnancy with at least 28 weeks of gestational age up to day-7 after birth. All babies born to those women were followed from birth until the seventh day after childbirth. Perinatal outcomes were considered at the end of the follow-up. MAIN OUTCOME MEASURES: Perinatal outcomes were (i) babies alive without severe complication, (ii) NNM and (iii) perinatal death (stillbirth and early neonatal death). RESULTS: 1219 births were analysed. Among them, 25.9% (n=316) and 10.1% (n=123) were NNM and perinatal deaths, respectively. After adjustment, maternal pre-existing medical condition (adjusted odds ratios (aOR)=1.5; 95% CI 1.1 to 2.0) and maternal infection suspected or diagnosed during labour (aOR=1.9; 95% CI 1.2 to 3.2) were the independent risk factors of NNM. Maternal pre-existing medical condition (aOR=1.7; 95% CI 1.0 to 2.8), infection-related severe maternal outcome (aOR=3.8; 95% CI 2.0 to 7.1), mother's infection suspected or diagnosed within 24 hours after childbirth (aOR=2.2; 95% CI 1.0 to 4.7) and vaginal birth (aOR=1.8; 95% CI 1.1 to 2.9) were independently associated with increased odds of perinatal death. CONCLUSIONS: Overall, one-third of births were adverse perinatal outcomes. Pre-existing maternal medical conditions and severe infection-related maternal outcomes were the main risk factors of adverse perinatal outcomes.

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epidemiology, neonatology

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<cfAbstr cfLangCode='EN' cfTrans='o'><p>OBJECTIVE: This study is part of the Global Maternal Sepsis Study (GLOSS). It aimed to estimate neonatal near-miss (NNM) and perinatal death frequency and maternal risk factors among births to women with infection during pregnancy in low-income and middle-income countries (LMIC). DESIGN: We conducted a 1-week inception hospital-based cohort study. SETTING: The study was carried out in 408 hospitals in 43 LMIC of all the WHO regions in 2017. PATIENTS: We included women with suspected or confirmed infection during pregnancy with at least 28 weeks of gestational age up to day-7 after birth. All babies born to those women were followed from birth until the seventh day after childbirth. Perinatal outcomes were considered at the end of the follow-up. MAIN OUTCOME MEASURES: Perinatal outcomes were (i) babies alive without severe complication, (ii) NNM and (iii) perinatal death (stillbirth and early neonatal death). RESULTS: 1219 births were analysed. Among them, 25.9% (n=316) and 10.1% (n=123) were NNM and perinatal deaths, respectively. After adjustment, maternal pre-existing medical condition (adjusted odds ratios (aOR)=1.5; 95% CI 1.1 to 2.0) and maternal infection suspected or diagnosed during labour (aOR=1.9; 95% CI 1.2 to 3.2) were the independent risk factors of NNM. Maternal pre-existing medical condition (aOR=1.7; 95% CI 1.0 to 2.8), infection-related severe maternal outcome (aOR=3.8; 95% CI 2.0 to 7.1), mother&#39;s infection suspected or diagnosed within 24 hours after childbirth (aOR=2.2; 95% CI 1.0 to 4.7) and vaginal birth (aOR=1.8; 95% CI 1.1 to 2.9) were independently associated with increased odds of perinatal death. CONCLUSIONS: Overall, one-third of births were adverse perinatal outcomes. Pre-existing maternal medical conditions and severe infection-related maternal outcomes were the main risk factors of adverse perinatal outcomes.&nbsp;</p></cfAbstr>
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