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. 2021 Oct;106(10):946-953.
doi: 10.1136/archdischild-2021-321865. Epub 2021 Sep 2.

Perinatal outcomes among births to women with infection during pregnancy

Adama Baguiya  1 , Mercedes Bonet  2 , José Guilherme Cecatti  3 , Vanessa Brizuela  2 , Ala Curteanu  4 , Meile Minkauskiene  5 , Kapila Jayaratne  6 , Carolina Carvalho Ribeiro-do-Valle  7 , Mihaela-Alexandra Budianu  8 , João Paulo Souza  9 , Séni Kouanda  10   11 ; WHO Global Maternal Sepsis Study (GLOSS) Research Group; GLOSS research group
Collaborators, Affiliations

Perinatal outcomes among births to women with infection during pregnancy

Adama Baguiya et al. Arch Dis Child. 2021 Oct.

Abstract

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.

Keywords: epidemiology; neonatology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Map of the world showing the included countries in blue.
Figure 2
Figure 2
Flowchart of the study. LMIC, low-income and middle-income countries.
See this image and copyright information in PMC

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