Recent research has shown that women in certain categories face a higher risk of developing potentially dangerous infections immediately after childbirth. Milder forms of such infections are known as sepsis, while more serious ones are labeled as severe sepsis. Both have become significantly more frequent over the past twenty years. Maternal death is very rare, but sepsis is its leading cause according to the recent study.
The researchers analyzed medical records for births in Scotland from 1986 to 2009, with the goal of identifying risks for sepsis in order to develop better preventive measures and to avoid pregnancy-related errors. They were already aware that cesarean section and anemia were the most frequent causes of maternal sepsis and suspected that obesity might also play a part.
In reviewing all the cases of sepsis in the Scottish births and comparing them with control groups, the researchers noticed there was about double the rate of sepsis among obese women, and the rate also doubled when doctors had to use forceps to assist with vaginal deliveries. Additionally, they found that women younger than age 25 were about five times as likely to develop ordinary sepsis as older women and ten times as likely to develop severe sepsis. Women who had given birth previously were more vulnerable to infection than first-time mothers.
The researchers found that induced labor brings with it five times the risk of maternal sepsis. About one in five labors in the United States are now induced. They suggest that limiting inductions to cases where there is some medical indication that induction is necessary would be a good idea.
As other measures to help prevent maternal sepsis, the researchers advise physicians to consistently use preventive antibiotics among mothers undergoing cesarean sections. They recommend using strict sterile technique in forceps deliveries, and suggest that antibiotics might be helpful.
For obese mothers-to-be, the study indicates that doctors need to monitor them more carefully during pregnancy and birth, paying attention to possible signs of infection. This new research provides doctors better guidance on which groups of women need to be monitored more closely during pregnancy.
Source: Modern Medicine, “New risk factors for maternal sepsis identified,” Mar. 15, 2012.