The utility of systemic inflammatory response syndrome (SIRS) for diagnosing sepsis in the immediate postpartum period

Abstract

Background: The systemic inflammatory response syndrome (SIRS) and sepsis definitions were developed to improve the ability for early detection of infection and sepsis. We studied the incidence of immediate postpartum SIRS and sepsis. We further studied immediate postpartum SIRS as a potential predictor for immediate postpartum sepsis.

Methods: This was a retrospective study of 638 immediate postpartum women who delivered either vaginally or by cesarean section. Multivariate logistic regression was used for statistical analysis. Predictor variables included demographic, labor and delivery, and SIRS variables to determine their association with acute immediate postpartum sepsis.

Results: We found that 72.10% of vital signs of immediate postpartum women met SIRS criteria while only 1.25% had sepsis. Both preterm gestational age of <37 weeks (OR:19.09, 95% CI:4.13, 88.36, p < 0.001) and only one of the four SIRS criteria of abnormal temperature (OR:25.90, 95% CI: 3.17, 211.52, p = 0.002) were each significantly associated with increased odds for sepsis.

Conclusion: Our findings suggest that immediate postpartum SIRS is not useful for the identification of immediate postpartum sepsis. Furthermore, SIRS does not appear to be a useful screening tool for infection and sepsis in the immediate postpartum period.

Keywords: Obstetrics; Sepsis; Systemic inflammatory response syndrome.