Peripartum infectious morbidity in women with preeclampsia
Autor: | Rachel Harrison, Leonard E. Egede, Anna Palatnik |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
030501 epidemiology Chorioamnionitis Article Preeclampsia 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Pregnancy medicine Peripartum Period Rupture of membranes Humans reproductive and urinary physiology Retrospective Studies 030219 obstetrics & reproductive medicine Obstetrics business.industry Infant Newborn Obstetrics and Gynecology Gestational age Retrospective cohort study medicine.disease female genital diseases and pregnancy complications Intrauterine pressure catheter Pediatrics Perinatology and Child Health Gestation Female Endometritis Morbidity 0305 other medical science business |
Zdroj: | J Matern Fetal Neonatal Med |
ISSN: | 1476-4954 |
Popis: | BACKGROUND Dysregulated maternal systemic inflammatory response is a commonly accepted component in the pathogenesis of preeclampsia. Chronic inflammation then occurs characterized by oxidative stress, proinflammatory cytokine production, and abnormal T-cell function. Infection results in similar physiologic changes. OBJECTIVE The objective of this study was to examine the association between the diagnosis of preeclampsia and the development of chorioamnionitis, postpartum fever, endometritis and wound infection. We hypothesize that the heightened chronic inflammatory state of preeclampsia increases the risk for maternal peripartum infection. STUDY DESIGN This was a retrospective cohort study from the Consortium on Safe Labor (CSL). In the present analysis, we included all women from the CSL database and compared their characteristics and pregnancy outcomes between those with and without a diagnosis of preeclampsia prior to labor. Women presenting with preterm prelabor rupture of membranes or were diagnosed with preeclampsia during labor or postpartum were excluded. The primary outcome was a composite of maternal peripartum infections including intrapartum chorioamnionitis, postpartum fever, endometritis, and wound infection. This outcome was compared between women with and without a diagnosis of preeclampsia prior to labor using univariable and multivariable analyses. RESULTS A total of 227,052 women were eligible for the analysis, of these 14,268 (6.3%) were diagnosed with preeclampsia. In univariable analysis, the rate of composite maternal peripartum infection was higher among women with preeclampsia (4.2 versus 3.8%, p = .026). When looking at each individual component, that rates of wound infection (1.0 versus 0.5%, p |
Databáze: | OpenAIRE |
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