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Rising Rates of Severe and Fatal Sepsis During Labor and Delivery

Study shows need for improved detection of sepsis for all women in labor (September 23)

According to a new study published in the October issue of Anesthesia & Analgesia, rates of severe sepsis and deaths from sepsis among U.S. women hospitalized for delivery have risen sharply over the last decade.

“Maternal severe sepsis and sepsis-related deaths are increasing in the United States,” concludes the report by Dr. Melissa E. Bauer and colleagues at the University of Michigan. Although the study identifies certain groups of women at increased risk, severe sepsis and death can occur during labor and delivery even in women with no recognized risk factors, the authors warn.

Using a national hospital database (the Nationwide Inpatient Sample), the investigators analyzed information on U.S. hospitalizations for delivery from 1998 through 2008.

Extrapolated to the entire U.S., the data represented approximately 45 million hospitalizations for delivery. Overall, sepsis occurred at a rate of 1 per every 3,333 women hospitalized for delivery. This rate did not change significantly over the 11-year period studied.

Severe sepsis occurred in about 1 out of 11,000 women. During the study period, the rate of severe sepsis approximately doubled: from about 1 in 15,400 to 1 in 7,250 women in labor.

Fatal sepsis occurred in about 1 out of 106,000 cases. Both severe and fatal sepsis increased by about 10% per year.

According to the authors, “this increase may have been due to similar factors as those identified in the United Kingdom… such as increasing microbial resistance, obesity, smoking, substance abuse, and poor general health.”

The study results also suggest that, while certain conditions increase the risk of severe and fatal sepsis, many cases occur in women with no recognized risk factors. That finding “underscores the need for developing systems of care that increase sensitivity for disease detection across the entire population,” the researchers conclude.

Source: EurekAlert; September 23, 2013.

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