Department of Obstetrics and Gynecology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Weizman 6, Tel Aviv, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Arch Gynecol Obstet. 2024 Jul;310(1):195-202. doi: 10.1007/s00404-024-07564-5. Epub 2024 May 26.
To assess the prevalence, microbial profile, and clinical risk factors of maternal bacteremia associated with intrapartum fever (IPF).
A retrospective cohort study, in a single tertiary university-affiliated medical center between 2012 and 2018. Demographic and labor characteristics of women, who delivered at term (37+0/7-41+6/7) and developed bacteremia following IPF were compared to a control group of women with IPF but without bacteremia.
During the study period there were 86,590 deliveries in our center. Of them, 2074 women (2.4%) were diagnosed with IPF, of them, for 2052 women (98.93%) the blood maternal cultures were available. In 26 patients (1.25%) maternal bacteremia was diagnosed. A lower rate of epidural anesthesia (84.6% vs 95.9%, p = 0.02) and a higher rate of antibiotics prophylaxis treatment prior to the onset of fever (30.8%.vs 12.1%, p = 0.006) were observed in patients who developed maternal bacteremia in comparison to those who have not. Maternal hyperpyrexia developed after initiation of antibiotics or without epidural anesthesia remained significantly associated with maternal bacteremia after applying a multivariate analysis, (Odds Ratio 3.14 95% CI 1.27-7.14, p = 0.009; 4.76 95% CI 1.35-12.5, p = 0.006; respectively).
Maternal fever developing after initiation of antibiotics or without epidural is associated with maternal bacteremia.
评估与产时发热（IPF）相关的产妇菌血症的患病率、微生物谱和临床危险因素。
这是一项回顾性队列研究，在 2012 年至 2018 年期间在一家单所三级大学附属医院进行。比较了在足月（37+0/7-41+6/7）分娩并在发生 IPF 后发生菌血症的妇女与 IPF 但无菌血症的对照组妇女的人口统计学和分娩特征。
在研究期间，我们中心有 86590 例分娩。其中，2074 名妇女（2.4%）被诊断为 IPF，其中 2052 名妇女（98.93%）的血母培养物可用。在 26 名患者（1.25%）中诊断出产妇菌血症。与未发生菌血症的患者相比，发生菌血症的患者硬膜外麻醉率较低（84.6% vs 95.9%，p=0.02），发热前抗生素预防治疗率较高（30.8% vs 12.1%，p=0.006）。在应用多变量分析后，抗生素治疗开始后或无硬膜外麻醉时发生的产妇高热与产妇菌血症仍显著相关，（优势比 3.14，95%置信区间 1.27-7.14，p=0.009；4.76，95%置信区间 1.35-12.5，p=0.006；分别）。
抗生素治疗开始后或无硬膜外麻醉时发生的产妇发热与产妇菌血症相关。
