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Cited by 114Global Maternal and Child HealthMaternal and fetal healthcareMaternal and Perinatal Health Interventions

Puerperal sepsis, the leading cause of maternal deaths at a Tertiary University Teaching Hospital in Uganda

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Ngonzi, Joseph, Tornes, Yarine Fajardo, Mukasa, Peter Kivunike, Salongo, Wasswa, Kabakyenga, Jerome, Sezalio, Masembe, Wouters, Kristien, Jacqueym, Yves +1 more·2016·BMC Pregnancy and Childbirth
DOI 10.1186/s12884-016-0986-9PMC PMC4974713
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Abstract

BACKGROUND: Maternal mortality is highest in sub-Saharan Africa. In Uganda, the WHO- MDG 5 (aimed at reducing maternal mortality by 75 % between 1990 and 2015) has not been attained. The current maternal mortality ratio (MMR) in Uganda is 438 per 100,000 live births coming from 550 per 100,000 in 1990. This study sets out to find causes and predictors of maternal deaths in a tertiary University teaching Hospital in Uganda. METHODS: The study was a retrospective unmatched case control study which was carried out at the maternity unit of Mbarara Regional Referral Hospital (MRRH). The sample included pregnant women aged 15-49 years admitted to the Maternity unit between January 2011 and November 2014. Data from patient charts of 139 maternal deaths (cases) and 417 controls was collected using a standard audit/data extraction form. Multivariable logistic regression analysis was used to assess for the factors associated with maternal mortality. RESULTS: Direct causes of mortality accounted for 77.7 % while indirect causes contributed 22.3 %. The most frequent cause of maternal mortality was puerperal sepsis (30.9 %), followed by obstetric hemorrhage (21.6 %), hypertensive disorders in pregnancy (14.4 %), abortion complications (10.8 %). Malaria was the commonest indirect cause of mortality accounting for 8.92 %. On multivariable logistic regression analysis, the factors associated with maternal mortality were: primary or no education (OR 1.9; 95 % CI, 1.0-3.3); HIV positive sero-status (OR, 3.6; 95 % CI, 1.9-7.0); no antenatal care attendance (OR 3.6; 95 % CI, 1.8-7.0); rural dwellers (OR, 4.5; 95 % CI, 2.5-8.3); having been referred from another health facility (OR 5.0; 95 % CI, 2.9-10.0); delay to seek health care (delay-1) (OR 36.9; 95 % CI, 16.2-84.4). CONCLUSIONS: Most maternal deaths occur among mothers from rural areas, uneducated, HIV positive, unbooked mothers (lack of antenatal care), referred mothers in critical conditions and mothers delaying to seek health care. Puerperal sepsis is the leading cause of maternal deaths at Mbarara Regional Referral Hospital. Therefore more research into puerperal sepsis to describe the microbiology and epidemiology of sepsis is recommended.

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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 [6]

    The Abstract Conclusions recommend more research on the microbiology and epidemiology of puerperal sepsis, and the Study limitations state that this study was retrospective. These passages support a research gap, but they do not establish that prospective studies of incidence are lacking or address antimicrobial resistance. No page numbers are available in our copy. (LLM, conf=0.83)

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Authors
Ngonzi, J., Tornes, Y. F., Mukasa, P. K., Salongo, W., Kabakyenga, J., Sezalio, M., Wouters, K., Jacqueym, Y., & Van Geertruyden, J.-P.
Affiliations
  • Mbarara University of Science and Technology (UG)
  • University of Antwerp (BE)
Corresponding author
Ngonzi, Joseph
ORCID
Venue
BMC Pregnancy and Childbirth
Publisher
Springer Science and Business Media LLC
Published
2016-08-05
Volume
16
Issue
1
Pages
207-207
ISSN
1471-2393 (ISSN-L)
DOI
10.1186/s12884-016-0986-9
PMC
PMC4974713
OpenAlex
W2477516493
Cited by
114
References
28
Citations by year
2026: 6 · 2025: 9 · 2024: 13 · 2023: 14 · 2022: 24 · 2021: 13 · 2020: 16 · 2019: 10 · 2018: 5 · 2017: 4
FWCI
7.37
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Pregnancy and Childbirth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
VLIR-UOS via the HEFS Platform Harvest Call (ZIUS2013VOA0902)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
puerperal fever, maternal mortality, causes of maternal death, obstetric hemorrhage, hypertensive disorders of pregnancy, abortion complications, malaria, risk factors for maternal death, HIV, prenatal care, rural residence, Uganda, sub-Saharan Africa, Mbarara Regional Referral Hospital
MeSH terms
Adolescent, Adult, Cause of Death, Educational Status, Female, Postpartum Hemorrhage, HIV Seropositivity, Hospitals, Teaching, Humans, Malaria, Maternal Mortality, Prenatal Care, Puerperal Infection, Retrospective Studies, Risk Factors, Rural Population, Uganda, Case-Control Studies, Sepsis, Hypertension, Pregnancy-Induced, Young Adult, Time-to-Treatment

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