Amer J Perinatol 2017; 34(11): 1148-1151
DOI: 10.1055/s-0037-1604245
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Risk Factors for Postpartum Septic Pelvic Thrombophlebitis: A Multicenter Cohort

Sarah K. Dotters-Katz1, Marcela C. Smid2, Matthew R. Grace1, Jennifer L. Thompson3, R. Phillips Heine4, Tracy Manuck1
  • 1Division of Maternal-Fetal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  • 2Division of Maternal-Fetal Medicine, University of Utah, Salt Lake City, Utah
  • 3Division of Maternal-Fetal Medicine, Vanderbilt University, Nashville, Tennessee
  • 4Division of Maternal-Fetal Medicine, Duke University, Durham, North Carolina
Further Information

Publication History

03 April 2017

12 June 2017

Publication Date:
13 July 2017 (eFirst)

Abstract

Objective The objective of this study was to identify risk factors associated with the development of septic pelvic thrombophlebitis (SPT).

Study Design This is a secondary case–control study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Unit Network Cesarean Registry. SPT was defined as suspected infectious thrombosis of the pelvic veins, often persistent febrile illness in the setting of antibiotic therapy for endometritis. Women with SPT were compared with those without SPT using descriptive statistics. Logistic regression models estimated the association between selected risk factors and SPT.

Results Of 73,087 women in the cohort, 89 (0.1%) developed SPT. Women with SPT were more likely to be < 20 years old (33.7 vs. 10.6%, p < 0.001), black race (58.4 vs. 29.1%, p < 0.001), and nulliparous (51.1 vs. 23.3%, p < 0.001). Hypertensive disorders of pregnancy (32.6 vs. 11.8%, p < 0.001) and multiple gestation (12.5 vs. 7.4%, p = 0.03) were also more common in women with SPT. In the multivariable regression model, maternal age < 20, black race, multiple gestation, and preeclampsia were all significantly associated with increased odds of SPT (adjusted odds ratio [aOR]: 1.96, 95% confidence interval [CI]: 1.22, 3.14; aOR: 2.6, 95% CI: 1.68, 4.02; aOR: 2.10, 95% CI: 1.13, 3.88; aOR: 2.91, 95% CI: 1.86, 4.57).

Conclusion SPT is a rare pregnancy complication. Our analysis confirmed known risk factors (e.g., infections, cesarean delivery), and identified novel ones, including black race, young age, preeclampsia, and multiple gestation.

Note

This article was presented in part at the 37th Annual Society of Maternal Fetal Medicine Meeting in 2017, Las Vegas, Nevada as a poster presentation.


Funding

None.