Abstract
Objective This study aims to examine physiological and laboratory parameters associated with
peripartum maternal bacteremia.
Study Design This case–control study matched 115 cases (women with fever and bacteremia during
the peripartum period) to 285 controls (defined as the next two febrile women with
negative blood cultures at the same institution) from two academic medical centers
from 2009 to 2013. Conditional logistic regression models were used to evaluate the
association of physiological and laboratory parameters with maternal bacteremia at
the time of initial and maximum fever.
Results At the time of initial fever, temperature > 103°F (adjusted odds ratio [aOR]: 5.58,
95% confidence interval [CI]: 2.05–15.19) and respiratory rate (RR) > 20 respirations
per minute (aOR: 5.27, 95% CI: 2.32–11.96) were associated with bacteremia. At the
time of maximum fever, temperature (> 102°F, aOR: 3.37, 95% CI: 1.61–7.06; > 103°F,
aOR: 7.96, 95% CI: 3.56–17.82), heart rate > 110 beats per minute (aOR: 2.20, 95%
CI: 1.21–3.99), and RR > 20 (aOR: 3.65, 95% CI: 1.65–8.08) were associated with bacteremia.
Bandemia > 10% (aOR: 2.44, 95% CI: 1.07–5.54) was associated with bacteremia.
Conclusion Physiological and laboratory parameters associated with maternal bacteremia differed
from those reported with sepsis in the adult critical care population. Further studies
of objective markers are needed to improve detection and treatment of peripartum bacteremia.
Keywords
bacteremia - infection - peripartum - sepsis - vital signs
