Original ResearchObstetricsDelivery-associated sepsis: trends in prevalence and mortality
Section snippets
Design, data source, and study sample
We conducted a serial cross-sectional analysis of delivery hospitalizations in the United States among women 15–49 years of age from Jan. 1, 2002, through Sept. 30, 2015, using data from the National Inpatient Sample (NIS).
The NIS, a product of the Healthcare Cost and Utilization Project developed through a federal-state-industry partnership, is the largest publicly available all-payer inpatient database in the United States. Forty-seven states and the District of Columbia currently contribute
Rate and temporal trends of delivery-associated sepsis
Of the more than 55 million delivery hospitalizations during the 14-year study period, 13,124 women met the criteria for sepsis, corresponding to 1 case of sepsis in every 4196 deliveries, or a rate of 2.4 per 10,000 delivery hospitalizations. The temporal trend in the prevalence of sepsis during pregnancy is displayed in Figure 1. The rate increased from 1.2 per 10,000 (95% CI, 1.0–1.5) to 3.7 per 10,000 (95% CI, 3.2–4.2) between 2002 and 2015. Joinpoint regression analyses estimated a
Comment
In an analysis of more than 55 million delivery-associated hospitalizations, we observed an increase in the rate of delivery-associated sepsis over a 14 year study period. However, the rate of sepsis-related in-hospital maternal mortality declined significantly during the last 6 years of the study. Patients older than age 40 years, insured by Medicaid, or with comorbidities were more likely to die prior to discharge.
The increase in maternal mortality rates in the United States, at a time when
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The authors report no conflict of interest.
Cite this article as: Kendle AM, Salemi JL, Tanner JP, Louis JM. Delivery-associated sepsis: trends in prevalence and mortality. Am J Obstet Gynecol. 2019;220:391.e1-16.