New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
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Jose Rojas-Suarez
,
Angel Paternina-Caicedo
Abstract
Objectives
We aimed to establish new cut-off values for SIRS (Systemic Inflammatory Response Syndrome) variables in the obstetric population.
Methods
A prospective cohort study in pregnant and postpartum women admitted with systemic infections between December 2017 and January 2019. Patients were divided into three cohorts: Group A, patients with infection but without severe maternal outcomes (SMO); Group B, patients with infection and SMO or admission to the intensive care unit (ICU); and Group C, a control group. Outcome measures were ICU admission and SMO. The relationship between SIRS criteria and SMO was expressed as the area under the receiver operating characteristics curve (AUROC), selecting the best cut-off for each SIRS criterion.
Results
A total of 541 obstetric patients were enrolled, including 341 with infections and 200 enrolled as the reference group (Group C). The patients with infections included 313 (91.7%) in Group A and 28 (8.2%) in Group B. There were significant differences for all SIRS variables in Group B, compared with Groups A and C, but there were no significant differences between Groups A and C. The best cut-off values were the following: temperature 38.2 °C, OR 4.1 (1.8–9.0); heart rate 120 bpm, OR 2.9 (1.2–7.4); respiratory rate 22 bpm, OR 4.1 (1.6–10.1); and leukocyte count 16,100 per mcl, OR 3.5 (1.6–7.6).
Conclusions
The cut-off values for SIRS variables did not differ between healthy and infected obstetric patients. However, a higher cut-off may help predict the population with a higher risk of severe maternal outcomes.
Funding source: Ministerio de Ciencia, Tecnologia e Innovación (MINCIENCIAS) http://dx.doi.org/10.13039/100007637
Award Identifier / Grant number: grant #815/2017
Funding source: Universidad de Cartagena
Award Identifier / Grant number: grant #02565/2017
Acknowledgments
A preliminary report of this data was presented at the North American Society of Obstetric Medicine Annual meeting on March 29th and 30th, 2019, in Vancouver, Canada.
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Research funding: This research was funded by the Universidad de Cartagena [grant #02565/2017] and Ministerio de Ciencia, Tecnologia e Innovación (MINCIENCIAS) [grant #815/2017].
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The Ethics Committee of Universidad de Cartagena and the Institutional Review Board of CMRC approved this study.
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Data availability: The patient data used to support the findings of this study are restricted by the Institutional Review Board of CMRC in order to protect patient privacy. Data are available from [Jose Rojas-Suarez, joseantonio.rojas.suarez@gricio.com] for researchers who meet the criteria for access to confidential data.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2021-0135).
© 2021 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
- Commentary
- Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
- WAPM Recommendations
- WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
- Corner of Academy
- Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
- Original Articles – Obstetrics
- The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
- Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
- Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
- Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
- Risk of metformin failure in the treatment of women with gestational diabetes
- Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
- New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
- Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
- Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
- Maternal and neonatal outcomes in women with disorders of lipid metabolism
- The use of PAMG-1 testing in patients with preterm labor, intact membranes and a short sonographic cervix reduces the rate of unnecessary antenatal glucocorticoid administration
- Original Articles – Neonates
- The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
- Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
- Impact of paternal presence and parental social-demographic characteristics on birth outcomes
- Letter to the Editor
- Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
Artikel in diesem Heft
- Frontmatter
- Review
- Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
- Commentary
- Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
- WAPM Recommendations
- WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
- Corner of Academy
- Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
- Original Articles – Obstetrics
- The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
- Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
- Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
- Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
- Risk of metformin failure in the treatment of women with gestational diabetes
- Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
- New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
- Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
- Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
- Maternal and neonatal outcomes in women with disorders of lipid metabolism
- The use of PAMG-1 testing in patients with preterm labor, intact membranes and a short sonographic cervix reduces the rate of unnecessary antenatal glucocorticoid administration
- Original Articles – Neonates
- The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
- Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
- Impact of paternal presence and parental social-demographic characteristics on birth outcomes
- Letter to the Editor
- Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
