Dear HIFA and CHIFA,
'Healthcare providers and policymakers in LMIC should strengthen hospitals' readiness and capacity to prevent and timely identify maternal infections and complications. To do so, facilities should address their needs for optimal skilled staff, equipment and drug availability for good quality emergency obstetric and newborn care.'
This is the conclusion of a new paper in Archives of Disease of Childhood (which continues to make its global child health content freely available.
Citation and abstract below.
CITATION: Baguiya A, Bonet M, Cecatti JG The WHO Global Maternal Sepsis Study (GLOSS) Research Group, et al. Perinatal outcomes among births to women with infection during pregnancy. Archives of Disease in Childhood 2021;106:946-953.
Objective: This study is part of the Global Maternal Sepsis Study (GLOSS). It aimed to estimate neonatal near-miss (NNM) and perinatal death frequency and maternal risk factors among births to women with infection during pregnancy in low-income and middle-income countries (LMIC).
Design: We conducted a 1-week inception hospital-based cohort study.
Setting: The study was carried out in 408 hospitals in 43 LMIC of all the WHO regions in 2017.
Patients: We included women with suspected or confirmed infection during pregnancy with at least 28 weeks of gestational age up to day-7 after birth. All babies born to those women were followed from birth until the seventh day after childbirth. Perinatal outcomes were considered at the end of the follow-up.
Main outcome measures: Perinatal outcomes were (i) babies alive without severe complication, (ii) NNM and (iii) perinatal death (stillbirth and early neonatal death).
Results: 1219 births were analysed. Among them, 25.9% (n=316) and 10.1% (n=123) were NNM and perinatal deaths, respectively. After adjustment, maternal pre-existing medical condition (adjusted odds ratios (aOR)=1.5; 95% CI 1.1 to 2.0) and maternal infection suspected or diagnosed during labour (aOR=1.9; 95% CI 1.2 to 3.2) were the independent risk factors of NNM. Maternal pre-existing medical condition (aOR=1.7; 95% CI 1.0 to 2.8), infection-related severe maternal outcome (aOR=3.8; 95% CI 2.0 to 7.1), mother’s infection suspected or diagnosed within 24 hours after childbirth (aOR=2.2; 95% CI 1.0 to 4.7) and vaginal birth (aOR=1.8; 95% CI 1.1 to 2.9) were independently associated with increased odds of perinatal death.
Conclusions: Overall, one-third of births were adverse perinatal outcomes. Pre-existing maternal medical conditions and severe infection-related maternal outcomes were the main risk factors of adverse perinatal outcomes.