Analysis of risk factors of postpartum sepsis / 中国医师进修杂志

ABSTRACT

Objective:To explore the risk factors of postpartum sepsis and provide references for clinical prevention of postpartum sepsis.Methods:The clinical data of postpartum patients who were treated and delivered in the maternity ward of Shengjing Hospital Affiliated of China Medical University from January 2016 to December 2018 were analyzed retrospectively. Among them, 99 patients with postpartum sepsis were assigned to the case group and 212 patients without postpartum sepsis in the same period were selected with a simple random method and as the control group. The clinical data of the two groups were collected by consulting the hospital electronic medical record system. Single factor and multivariate Logistic regression were applied to analyze the risk factors of postpartum sepsis.Results:The infection sites of 99 postpartum sepsis patients were mainly genital tract and respiratory system, accounting for 28.28% (28/99) and 26.26% (26/99), respectively. In blood culture of 99 cases of postpartum sepsis patients, 58.59% (58/99) pathogens of Gram-positive bacteria were detected with the highest proportion, among which Streptococcus was mainly, accounting for 23.23%(23/99). The proportion of Gram-negative bacteria was 38.38%(38/99), and Escherichia coli was mainly, accounting for 31.31% (31/99). Multivariate Logistic analysis showed that gestational diabetes ( OR = 2.643, 95% CI 1.123 - 6.276), genital tract infection ( OR = 7.542, 95% CI 3.571-15.959), vaginal trial (switch to cesarean section) ( OR = 1.218, 95% CI 1.008-1.493), premature rupture of membranes ( OR = 1.152, 95% CI 1.019 - 1.449), postpartum hemorrhage ( OR = 1.562, 95% CI 1.263 -1.881) and cesarean delivery ( OR = 2.074, 95% CI 1.442 - 2.993) were the risk factors of postpartum sepsis. Conclusions:The main risk factors affecting postpartum sepsis includes gestational diabetes, genital tract infection, vaginal trial (switch to cesarean section), premature rupture of membranes, postpartum hemorrhage and cesarean delivery. It is necessary to take corresponding intervention measures to strengthen prevention of these risk factors, which is of great significance for prevention and treatment of postpartum sepsis.