No Cover Image

Journal article 303 views 52 downloads

Maternal physiological parameters and routine laboratory tests to screen for maternal sepsis: an observational cohort study

T Culling, C Bertorelli, A Strang, S Oram, F Faggian, S Sharma, A Ridgeway, Summia Zaher, Mario Labeta, Simon A Jones, Luke Davies Orcid Logo, John Watkins, Kate Siddall, Vikki Keeping, Kathryn Simpson, Maryanne Bray, Peter Ghazal, Sarah F Bell, Rachel E Collis

International Journal of Obstetric Anesthesia, Volume: 63, Start page: 104683

Swansea University Author: Luke Davies Orcid Logo

  • 69675.VOR.pdf

    PDF | Version of Record

    © 2025 The Authors. This is an open access article distributed under the terms of the Creative Commons CC-BY license.

    Download (2.26MB)

Check full text

DOI (Published version): 10.1016/j.ijoa.2025.104683

Abstract

Maternal sepsis can lead to poor outcomes for the mother and neonate, and early diagnosis and treatment of infection is important to prevent sepsis. Current guidance to recognise maternal sepsis includes assessment of physiological markers, however normal physiological changes of pregnancy can hinde...

Full description

Published in: International Journal of Obstetric Anesthesia
ISSN: 0959-289X 1532-3374
Published: Elsevier Ltd 2025
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa69675
Abstract: Maternal sepsis can lead to poor outcomes for the mother and neonate, and early diagnosis and treatment of infection is important to prevent sepsis. Current guidance to recognise maternal sepsis includes assessment of physiological markers, however normal physiological changes of pregnancy can hinder the diagnosis of sepsis. This study investigated the utility of routine clinical variables, including laboratory tests, in screening for maternal sepsis. Patients considered at risk of obstetric sepsis were recruited into a single centre cohort study. Microbiological, histological and clinical data categorised patients into three diagnostic groups: 'infection confirmed', 'infection unknown' and 'infection unlikely'. Differences in physiological and routine laboratory variables were investigated. Between November 2020 and December 2022, 154 pregnant patients were recruited. Comparison between 'infection confirmed' (n=58) and 'infection unlikely' (n=17) showed statistical differences in temperature (P <0.001), neutrophil count (P =0.003) and leukocyte count (P =0.004) at the time of recruitment. Temperature was the best discriminator with an area under the receiver operating characteristic curve (AUC-ROC) of 0.82 (95% CI 0.70 to 0.94, P <0.0001) with an optimal threshold of ≥37.5°C. This observational cohort study demonstrated that maternal temperature ≥37.5°C (rather than the threshold of 38°C found in most screening tools) may be important in screening patients at risk of developing maternal sepsis. When temperature ≥37.5°C persists, medical care should be expedited and maternal infection considered.
Item Description: Brief Report
Keywords: Diagnosis; Fever; Infection; Pregnancy; Sepsis; Maternal morbidity; Maternal mortality; MEOWS
College: Faculty of Medicine, Health and Life Sciences
Funders: This project was funded by a grant awarded by the National Institute of Academic Anaesthesia (NIAA19R103). Additional funding provided by the Welsh Government through the European Regional Development Fund (Ser Cymru Grant Program: 80762-CU-106) awarded to PG for Project Sepsis. LCD is funded by a Medical Research Council New Investigator Research Grant (MR/Y013816/1). SFB is funded by a Health and Care Research Wales Research Time Award.
Start Page: 104683

Similar Items