Table 4.
Nested case-control study for women with postpartum sepsis.
| Cases (N = 150) |
Controls (N = 297) | Crude OR | Adjusted OR | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| N | % | N | % | OR | 95% CI | aOR | 95% CI | ||||
| Maternal age (years) | <35 | 103 | 68.7 | 167 | 56.2 | 1.00 | 1.00 | ||||
| ≥35 | 47 | 31.3 | 103 | 34.7 | 0.58 | 0.38 | 0.88 | 0.80 | 0.42 | 1.54 | |
| Citizenship a | Italian | 96 | 64.0 | 223 | 75.1 | 1.00 | 1.00 | ||||
| Foreign | 52 | 34.7 | 72 | 24.2 | 1.72 | 1.11 | 2.68 | 1.39 | 0.67 | 2.88 | |
| Education a | Low | 40 | 26.7 | 68 | 22.9 | 1.19 | 0.73 | 1.94 | 1.16 | 0.51 | 2.64 |
| High | 101 | 67.3 | 199 | 67.0 | 1.00 | 1.00 | |||||
| Parity | Nulliparas | 88 | 58.7 | 132 | 44.4 | 1.80 | 1.21 | 2.69 | 1.76 | 0.94 | 3.26 |
| Multiparas | 62 | 41.3 | 165 | 55.6 | 1.00 | 1.00 | |||||
| BMI a | <18.5 | 9 | 6.0 | 18 | 6.1 | 1.00 | 0.42 | 2.43 | 1.24 | 0.34 | 4.57 |
| 18.5–24.9 | 82 | 54.7 | 165 | 55.6 | 1.00 | 1.00 | |||||
| 25–29.9 | 32 | 21.3 | 61 | 20.5 | 1.05 | 0.64 | 1.73 | 1.26 | 0.57 | 2.79 | |
| ≥30 | 19 | 12.7 | 32 | 10.8 | 1.16 | 0.63 | 2.15 | 0.78 | 0.27 | 2.23 | |
| History of STIs a | No | 289 | 192.7 | 142 | 47.8 | 1.00 | 1.00 | ||||
| Yes | 7 | 4.7 | 8 | 2.7 | 2.46 | 0.84 | 7.17 | 2.70 | 0.50 | 14.44 | |
| Prior recurrent infections a | No | 122 | 81.3 | 274 | 92.3 | 1.00 | 1.00 | ||||
| Yes | 19 | 12.7 | 15 | 5.1 | 3.08 | 1.46 | 6.47 | 2.68 | 0.99 | 7.27 | |
| Pregestational medical conditions | No | 89 | 59.3 | 226 | 76.1 | 1.00 | 1.00 | ||||
| Yes | 61 | 40.7 | 71 | 23.9 | 2.22 | 1.44 | 3.43 | 1.93 | 1.00 | 3.69 | |
| Medical and obstetric history-associated risk factors | |||||||||||
| Amniocentesis | No | 144 | 96.0 | 292 | 98.3 | 1.00 | 1.00 | ||||
| Yes | 6 | 4.0 | 5 | 1.7 | 2.51 | 0.69 | 9.09 | 3.43 | 0.59 | 19.83 | |
| PROM | No | 129 | 86.0 | 282 | 94.9 | 1.00 | 1.00 | ||||
| Yes | 21 | 14.0 | 15 | 5.1 | 3.18 | 1.55 | 6.51 | 3.08 | 0.99 | 9.53 | |
| Complications in current pregnancy b | No | 105 | 70.0 | 260 | 87.5 | 1.00 | 1.00 | ||||
| Yes | 45 | 30.0 | 37 | 12.5 | 3.52 | 2.02 | 6.12 | 1.93 | 0.80 | 4.64 | |
| Childbirth complications | No | 128 | 85.3 | 283 | 95.3 | 1.00 | 1.00 | ||||
| Yes | 22 | 14.7 | 14 | 4.7 | 3.87 | 1.81 | 8.25 | 1.59 | 0.50 | 5.07 | |
| PPH > 500 mL | No | 117 | 78.0 | 265 | 89.2 | 1.00 | 1.00 | ||||
| Yes | 33 | 22.0 | 32 | 10.8 | 2.40 | 1.38 | 4.18 | 2.04 | 0.89 | 4.69 | |
| Vascular catheters | No | 76 | 50.7 | 235 | 79.1 | 1.00 | 1.00 | ||||
| Yes | 74 | 49.3 | 62 | 20.9 | 40.84 | 9.89 | 168.61 | 9.02 | 1.53 | 53.09 | |
| Intermittent bladder catheterization | No | 138 | 92.0 | 291 | 98.0 | 1.00 | 1.00 | ||||
| Yes | 12 | 8.0 | 6 | 2.0 | 10.00 | 2.19 | 45.64 | 5.22 | 0.56 | 48.90 | |
| Indwelling bladder catheterization | No | 76 | 50.7 | 237 | 79.8 | 1.00 | 1.00 | ||||
| Yes | 74 | 49.3 | 60 | 20.2 | 41.84 | 10.14 | 172.6 | 9.86 | 2.00 | 48.62 | |
| >5 vaginal explorations a | No | 109 | 72.7 | 229 | 77.1 | 1.00 | 1.00 | ||||
| Yes | 33 | 22.0 | 35 | 11.8 | 2.16 | 1.20 | 3.88 | 1.78 | 0.79 | 4.00 | |
a Percentages and odds-ratios calculated including “unknown information” in the analysis. b Gestational complications (% in cases and controls): anemia (10.9–3.3%); severe infection (2.7–0.3%); respiratory distress syndrome prophylaxis (11.4–4.4%); threatening preterm labor (7.1–3.6%); vagino-rectal swab and/or urine culture positive for GBS (7.6–3.1%). STIs, sexually transmitted infections: HIV, syphilis, N. gonorrhea, C. trachomatis, genital herpes, hepatitis B, and hepatitis C. Prior recurrent infections: recurrent otitis, skin infections, cystitis, pyelonephritis, vaginal infections. Pregestational medical conditions: cardiac disease, diabetes, endocrine disorders, mental health disorder/psychiatric disease, anemia or other hematological conditions, inflammatory bowel diseases, renal disease, autoimmune conditions, cancer. Complications in current pregnancy: amniotic fluid embolism, hypertensive disorders of pregnancy, gestational diabetes, hyperemesis gravidarum requiring hospital admission, ovarian hyperstimulation syndrome, small or large for gestational age neonate, placenta previa, placenta abruptio, postpartum hemorrhage requiring blood transfusion, preterm delivery, thromboembolic event, infection requiring hospital admission, stillbirth, surgery in pregnancy, neonatal death. Childbirth complications: hysterectomy, allergic reactions/anaphylaxis, anesthesiology complications. BMI, Body Mass Index; PROM, premature rupture of membranes; PPH, postpartum hemorrhage.