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Cited by 289Neonatal and Maternal InfectionsSepsis Diagnosis and TreatmentStreptococcal Infections and Treatments

Maternal sepsis: epidemiology, etiology and outcome

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van Dillen, Jeroen, Zwart, Joost, Schutte, Joke, van Roosmalen, Jos·2010·Current Opinion in Infectious Diseases
DOI 10.1097/qco.0b013e328339257c
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Abstract

PURPOSE OF REVIEW: Sepsis is a major cause of maternal death worldwide. Little is known on the incidence of severe maternal morbidity related to sepsis. In this review, we focus on new findings concerning epidemiology, etiology and outcome of maternal sepsis in low-income as well as high-income countries. RECENT FINDINGS: It is estimated that puerperal sepsis causes at least 75,000 maternal deaths every year, mostly in low-income countries. Studies from high-income countries report incidence of maternal morbidity due to sepsis of 0.1-0.6 per 1000 deliveries. The causative microorganisms are generally polymicrobial with beta-haemolytic streptococci group A (GAS) often being the cause of severe cases of puerperal fever. The single most important risk factor for postpartum infection seems to be caesarean section, and prophylactic antibiotics during the procedure substantially reduce the infection risk. Improvements in service provision as promoted through the Surviving Sepsis Campaign can reduce the overall risk of mortality and morbidity from maternal sepsis in high-income as well as in low-income countries. SUMMARY: Maternal sepsis is an infrequent, but important complication of pregnancy, childbirth and puerperium, resulting in significant maternal morbidity and mortality worldwide. Improved outcome is possible through improved service provision.

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  • Prospective studies on the incidence, microbiology and antimicrobial resistance of postpartum infections are lacking.

    “prospective studies on incidence, microbiology and antimicrobial resistance are lacking.”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [3]

    The Epidemiology section says most maternal-sepsis estimates, especially in low-income countries, come from retrospective studies without clinical investigations, supporting a shortage of prospective incidence data. It does not say that prospective studies of postpartum-infection microbiology or antimicrobial resistance are lacking, and its wording is narrower than a blanket claim that prospective studies are lacking. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The most common postpartum infections include endometritis (puerperal sepsis), urinary tract infections, bloodstream infections, and cesarean surgical site infections.

    “The most common postpartum infections include endometritis (puerperal sepsis), urinary tract infections (UTIs), bloodstream infections, and cesarean surgical site infections.[3, 5, 7]”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [3]

    The Etiology section identifies endometritis and urinary tract infections and reports bacteraemia among cases of postpartum invasive group A streptococcal infection. The Outcome section discusses wound infections after caesarean section. These passages support the infection types, but they do not establish that all four are among the most common postpartum infections; the bacteraemia finding concerns a specific, uncommon infection. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Peri-procedural antibiotic prophylaxis reduces the risk of postpartum infection significantly.

    “Cesarean delivery is considered the single most important risk factor for postpartum infection due to skin and uterine disruption, bladder catheterization, and healthcare system contact, though peri-procedural antibiotic prophylaxis reduces the risk significantly.[3, 8]”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [3]

  • Cesarean delivery is the single most important risk factor for postpartum infection.

    “Cesarean delivery is considered the single most important risk factor for postpartum infection due to skin and uterine disruption, bladder catheterization, and healthcare system contact, though peri-procedural antibiotic prophylaxis reduces the risk significantly.[3, 8]”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [3]

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Research works printed but not linked: 36

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Authors
van Dillen, J., Zwart, J., Schutte, J., & van Roosmalen, J.
Affiliations
  • Leiden University Medical Center (NL)
  • Isala (NL)
ORCID
Venue
Current Opinion in Infectious Diseases
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-06
Volume
23
Issue
3
Pages
249-254
ISSN
0951-7375 (ISSN-L)
DOI
10.1097/qco.0b013e328339257c
OpenAlex
W2406424169
Cited by
289
References
1
Citations by year
2026: 5 · 2025: 10 · 2024: 27 · 2023: 14 · 2022: 17 · 2021: 26 · 2020: 24 · 2019: 52 · 2018: 15 · 2017: 15 · 2016: 17 · 2015: 11 · 2014: 12 · 2013: 23 · 2012: 6
FWCI
2.03
Type
journal article
Language
en
Open access
Locations
  • Current Opinion in Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
Keywords
maternal sepsis, puerperal fever, maternal mortality, postpartum infection, cesarean section, antibiotic prophylaxis, Surviving Sepsis Campaign, low-income countries, high-income countries, sepsis epidemiology, sepsis etiology, sepsis outcomes
MeSH terms
Female, Humans, Pregnancy, Pregnancy Complications, Infectious, Puerperal Infection, Treatment Outcome, Sepsis

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