Department of Hospital Infection Control, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
Department of Obstetrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
BMC Pregnancy Childbirth. 2023 Nov 23;23(1):815. doi: 10.1186/s12884-023-06135-x.
Puerperal infection (PI) is a severe threat to maternal health. The incidence and risk of PI should be accurately quantified and conveyed for prior decision-making. This study aims to assess the quality of the published literature on the epidemiology of PI, and synthesize them to identify the temporal trends and risk factors of PI occurring in Mainland China.
This review was registered in PROSPERO (CRD42021267399). Putting a time frame on 2010 to March 2022, we searched Cochrane library, Embase, Google Scholar, MEDLINE, Web of Science, China biology medicine, China national knowledge infrastructure and Chinese medical current contents, and performed a meta-analysis and meta-regression to pool the incidence of PI and the effects of risk factors on PI.
A total of 49 eligible studies with 133,938 participants from 17 provinces were included. The pooled incidence of PI was 4.95% (95%CIs, 4.46-5.43), and there was a statistical association between the incidence of PI following caesarean section and the median year of data collection. Gestational hypertension (OR = 2.14), Gestational diabetes mellitus (OR = 1.82), primipara (OR = 0.81), genital tract inflammation (OR = 2.51), anemia during pregnancy (OR = 2.28), caesarean section (OR = 2.03), episiotomy (OR = 2.64), premature rupture of membrane (OR = 2.54), prolonged labor (OR = 1.32), placenta remnant (OR = 2.59) and postpartum hemorrhage (OR = 2.43) have significant association with PI.
Maternal infection remains a crucial complication during puerperium in Mainland China, which showed a nationwide temporal rising following caesarean section in the past decade. The opportunity to prevent unnecessary PI exists in several simple but necessary measures and it's urgent for clinicians and policymakers to focus joint efforts on promoting the bundle of evidence-based practices.
产褥期感染（PI）是对产妇健康的严重威胁。应准确量化和传达 PI 的发生率和风险，以便提前做出决策。本研究旨在评估已发表的关于 PI 流行病学的文献质量，并对其进行综合分析，以确定中国内地 PI 的时间趋势和危险因素。
本综述已在 PROSPERO（CRD42021267399）上注册。设定时间范围为 2010 年至 2022 年 3 月，我们检索了 Cochrane 图书馆、Embase、Google Scholar、MEDLINE、Web of Science、中国生物医学文献数据库、中国国家知识基础设施和中国医学现刊数据库，并进行了荟萃分析和荟萃回归，以汇总 PI 的发生率和危险因素对 PI 的影响。
共纳入 17 个省份的 49 项符合条件的研究，共 133938 名参与者。PI 的总发生率为 4.95%（95%CI，4.46-5.43），剖宫产术后 PI 的发生率与数据采集的中位年份之间存在统计学关联。妊娠期高血压（OR=2.14）、妊娠期糖尿病（OR=1.82）、初产妇（OR=0.81）、生殖道炎症（OR=2.51）、妊娠期贫血（OR=2.28）、剖宫产术（OR=2.03）、会阴切开术（OR=2.64）、胎膜早破（OR=2.54）、产程延长（OR=1.32）、胎盘残留（OR=2.59）和产后出血（OR=2.43）与 PI 有显著关联。
在中国内地，产妇感染仍然是产褥期的一个重要并发症，在过去十年中，剖宫产术后呈全国性的时间上升趋势。在几个简单但必要的措施中存在预防不必要的 PI 的机会，临床医生和政策制定者迫切需要共同努力，推广基于证据的实践措施。
