Am J Perinatol 2015; 32(14): 1342-1350
DOI: 10.1055/s-0035-1565995
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Defining Physiological Predictors of Peripartum Maternal Bacteremia

Rose L. Molina
1   Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts
,
Sarah Rae Easter
1   Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts
,
Kartik K. Venkatesh
1   Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts
,
David E. Cantonwine
2   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
,
Anjali J. Kaimal
3   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts
,
Ruth E. Tuomala
2   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
,
Laura E. Riley
3   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

03 August 2015

05 September 2015

Publication Date:
21 October 2015 (online)

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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.

Abstract #705 presented at The 35th Annual Pregnancy Meeting, Society of Maternal-Fetal Medicine, February 2015.