PDF(Pubmed)
Abstract：
BACKGROUND: To investigate the association between maternal sepsis during pregnancy and poor pregnancy outcome and to identify risk factors for poor birth outcomes and adverse perinatal events.
METHODS: We linked the Taiwan Birth Cohort Study (TBCS) database and the Taiwanese National Health Insurance Database (NHID) to conduct this population-based study. We analysed the data of pregnant women who met the criteria for sepsis-3 during pregnancy between 2005 and 2017 as the maternal sepsis cases and selected pregnant women without infection as the non-sepsis comparison cohort. Sepsis during pregnancy and fulfilled the sepsis-3 definition proposed in 2016. The primary outcome included low birth weight (LBW, < 2500 g) and preterm birth (< 34 weeks), and the secondary outcome was the occurrence of adverse perinatal events.
RESULTS: We enrolled 2,732 women who met the criteria for sepsis-3 during pregnancy and 196,333 non-sepsis controls. We found that the development of maternal sepsis was highly associated with unfavourable pregnancy outcomes, including LBW (adjOR 9.51, 95% CI 8.73-10.36), preterm birth < 34 weeks (adjOR 11.69, 95%CI 10.64-12.84), and the adverse perinatal events (adjOR 3.09, 95% CI 2.83-3.36). We also identified that socio-economically disadvantaged status was slightly associated with an increased risk for low birth weight and preterm birth.
CONCLUSIONS: We found that the development of maternal sepsis was highly associated with LBW, preterm birth and adverse perinatal events. Our findings highlight the prolonged impact of maternal sepsis on pregnancy outcomes and indicate the need for vigilance among pregnant women with sepsis.
METHODS: We linked the Taiwan Birth Cohort Study (TBCS) database and the Taiwanese National Health Insurance Database (NHID) to conduct this population-based study. We analysed the data of pregnant women who met the criteria for sepsis-3 during pregnancy between 2005 and 2017 as the maternal sepsis cases and selected pregnant women without infection as the non-sepsis comparison cohort. Sepsis during pregnancy and fulfilled the sepsis-3 definition proposed in 2016. The primary outcome included low birth weight (LBW, < 2500 g) and preterm birth (< 34 weeks), and the secondary outcome was the occurrence of adverse perinatal events.
RESULTS: We enrolled 2,732 women who met the criteria for sepsis-3 during pregnancy and 196,333 non-sepsis controls. We found that the development of maternal sepsis was highly associated with unfavourable pregnancy outcomes, including LBW (adjOR 9.51, 95% CI 8.73-10.36), preterm birth < 34 weeks (adjOR 11.69, 95%CI 10.64-12.84), and the adverse perinatal events (adjOR 3.09, 95% CI 2.83-3.36). We also identified that socio-economically disadvantaged status was slightly associated with an increased risk for low birth weight and preterm birth.
CONCLUSIONS: We found that the development of maternal sepsis was highly associated with LBW, preterm birth and adverse perinatal events. Our findings highlight the prolonged impact of maternal sepsis on pregnancy outcomes and indicate the need for vigilance among pregnant women with sepsis.
摘要：
背景：探讨妊娠期间产妇败血症与不良妊娠结局之间的关系，并确定不良分娩结局和不良围产期事件的危险因素。
方法：我们将台湾出生队列研究（TBCS）数据库和台湾国民健康保险数据库（NHID）联系起来，进行这项基于人群的研究。我们分析了2005年至2017年在妊娠期间符合脓毒症-3标准的孕妇作为孕产妇脓毒症病例的数据，并选择未感染的孕妇作为非脓毒症比较队列。妊娠期脓毒症，符合2016年提出的脓毒症-3定义。主要结局包括低出生体重（LBW，<2500克）和早产（<34周），次要结局是不良围产期事件的发生。
结果：我们招募了2,732名怀孕期间符合败血症-3标准的女性和196,333名非败血症对照。我们发现母体败血症的发展与不良的妊娠结局高度相关，包括LBW(调整9.51，95%CI8.73-10.36)，早产<34周（调整11.69，95CI10.64-12.84），和不良围产期事件（adjOR3.09，95%CI2.83-3.36）。我们还发现，社会经济上处于不利地位与低出生体重和早产的风险增加略有相关。
结论：我们发现母体败血症的发生与LBW高度相关，早产和不良围产期事件。我们的发现强调了产妇败血症对妊娠结局的长期影响，并表明败血症孕妇需要保持警惕。
方法：我们将台湾出生队列研究（TBCS）数据库和台湾国民健康保险数据库（NHID）联系起来，进行这项基于人群的研究。我们分析了2005年至2017年在妊娠期间符合脓毒症-3标准的孕妇作为孕产妇脓毒症病例的数据，并选择未感染的孕妇作为非脓毒症比较队列。妊娠期脓毒症，符合2016年提出的脓毒症-3定义。主要结局包括低出生体重（LBW，<2500克）和早产（<34周），次要结局是不良围产期事件的发生。
结果：我们招募了2,732名怀孕期间符合败血症-3标准的女性和196,333名非败血症对照。我们发现母体败血症的发展与不良的妊娠结局高度相关，包括LBW(调整9.51，95%CI8.73-10.36)，早产<34周（调整11.69，95CI10.64-12.84），和不良围产期事件（adjOR3.09，95%CI2.83-3.36）。我们还发现，社会经济上处于不利地位与低出生体重和早产的风险增加略有相关。
结论：我们发现母体败血症的发生与LBW高度相关，早产和不良围产期事件。我们的发现强调了产妇败血症对妊娠结局的长期影响，并表明败血症孕妇需要保持警惕。
