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• W4238104096 abstract "Abstract Background: Majority (99%) of maternal deaths occur in low and middle income countries. The three most important causes of maternal deaths in these regions are postpartum hemorrhage, pre-eclampsia and puerperal sepsis. There are several diagnostic criteria used to identify sepsis and one of the commonly used criterion is systematic inflammatory response syndrome (SIRS). However, these criteria require laboratory investigations which may not be feasible in resource constrained settings. Therefore, this study aimed to develop a model based on risk factors and clinical signs and symptoms that can identify sepsis early among postpartum women. Methods: A case control study was nested in an ongoing cohort of 4000 postpartum women who delivered or were admitted in study hospital. According to standard criteria of SIRS, 100 women with sepsis (cases) and 498 women without sepsis (controls) were recruited from January to July 2017. Information related to socio-demographic status, antenatal care and maternal life styles were obtained via interview while pregnancy and delivery related information, comorbid and clinical sign and symptoms were retrieved from ongoing cohort. Multivariable logistic regression was performed and discriminative performance of the model was assessed using area under the curve (AUC) of the receiver operating characteristic (ROC). Results: Multivariable analysis revealed that 1-4 antenatal visits (95% CI 0.01 - 0.62), 3 or more vaginal examinations (95% CI 1.21 - 3.65), home delivery (95% CI 1.72-50.02), preterm delivery, diabetes in pregnancy (95% CI 1.93-20.23), lower abdominal pain (95% CI 1.15 - 3.42)) vaginal discharge (95% CI 2.97-20.21), SpO2 <93% (95% CI 4.80-37.10) and blood glucose were significantly associated with sepsis. AUC was 0.84 (95% C.I 0.80-0.89) which indicated that risk factors and clinical sign and symptoms based model has adequate ability to discriminate women with and without sepsis. Conclusion: This study developed a non-invasive tool which can identify postpartum women with sepsis as accurately as SIRS criteria with good discriminative ability. Once validated, this tool has a potential to be scaled up for community use by frontline health care workers." @default.
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• W4238104096 date "2020-01-28" @default.
• W4238104096 modified "2023-09-27" @default.
• W4238104096 title "Risk factors for postpartum sepsis: A nested case control study" @default.
• W4238104096 doi "https://doi.org/10.21203/rs.2.22098/v1" @default.
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