TY - JOUR
T1 - Severe sepsis in women with group B Streptococcus in pregnancy
T2 - an exploratory UK national case-control study
AU - Kalin, Asli
AU - Acosta, Colleen
AU - Kurinczuk, Jennifer J
AU - Brocklehurst, Peter
AU - Knight, Marian
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
PY - 2015/10/8
Y1 - 2015/10/8
N2 - OBJECTIVE: To estimate the incidence of severe maternal sepsis due to group B Streptococcus (GBS) in the UK, and to investigate the associated outcomes for mother and infant.DESIGN: National case-control study.SETTING: All UK consultant-led maternity units.PARTICIPANTS: 30 women with confirmed or suspected severe GBS sepsis, and 757 control women.MAIN OUTCOME MEASURES: Disease incidence, additional maternal morbidity, critical care admission, length of stay, infant infection, mortality.RESULTS: The incidences of confirmed and presumed severe maternal GBS sepsis were 1.00 and 2.75 per 100,000 maternities, respectively, giving an overall incidence of 3.75 per 100,000. Compared with controls, severe GBS sepsis was associated with higher odds of additional maternal morbidity (OR 12.35, 95% CI 3.96 to 35.0), requiring level 2 (OR 39.3, 95% CI 16.0 to 99.3) or level 3 (OR 182, 95% CI 21.0 to 8701) care and longer hospital stay (median stay in cases and controls was 7 days (range 3-29 days) and 2 days (range 0-16 days), respectively, p<0.001). None of the women died. Severe maternal GBS sepsis was associated with higher odds of infant sepsis (OR 32.7, 95% CI 8.99 to 119.0); 79% of infants, however, did not develop sepsis. There were no associated stillbirths or neonatal deaths.CONCLUSIONS: Severe maternal GBS sepsis is a rare occurrence in the UK. It is associated with adverse maternal and neonatal outcomes.
AB - OBJECTIVE: To estimate the incidence of severe maternal sepsis due to group B Streptococcus (GBS) in the UK, and to investigate the associated outcomes for mother and infant.DESIGN: National case-control study.SETTING: All UK consultant-led maternity units.PARTICIPANTS: 30 women with confirmed or suspected severe GBS sepsis, and 757 control women.MAIN OUTCOME MEASURES: Disease incidence, additional maternal morbidity, critical care admission, length of stay, infant infection, mortality.RESULTS: The incidences of confirmed and presumed severe maternal GBS sepsis were 1.00 and 2.75 per 100,000 maternities, respectively, giving an overall incidence of 3.75 per 100,000. Compared with controls, severe GBS sepsis was associated with higher odds of additional maternal morbidity (OR 12.35, 95% CI 3.96 to 35.0), requiring level 2 (OR 39.3, 95% CI 16.0 to 99.3) or level 3 (OR 182, 95% CI 21.0 to 8701) care and longer hospital stay (median stay in cases and controls was 7 days (range 3-29 days) and 2 days (range 0-16 days), respectively, p<0.001). None of the women died. Severe maternal GBS sepsis was associated with higher odds of infant sepsis (OR 32.7, 95% CI 8.99 to 119.0); 79% of infants, however, did not develop sepsis. There were no associated stillbirths or neonatal deaths.CONCLUSIONS: Severe maternal GBS sepsis is a rare occurrence in the UK. It is associated with adverse maternal and neonatal outcomes.
KW - Adult
KW - Female
KW - Great Britain
KW - Humans
KW - Incidence
KW - Pregnancy
KW - Pregnancy Complications, Infectious
KW - Risk Factors
KW - Sepsis
KW - Streptococcal Infections
KW - Streptococcus agalactiae
KW - Journal Article
KW - Multicenter Study
KW - Research Support, Non-U.S. Gov't
U2 - 10.1136/bmjopen-2015-007976
DO - 10.1136/bmjopen-2015-007976
M3 - Article
C2 - 26450426
SN - 2044-6055
VL - 5
SP - e007976
JO - BMJ open
JF - BMJ open
ER -