PMID- 34475107 OWN - NLM STAT- MEDLINE DCOM- 20211122 LR - 20220129 IS - 1468-2044 (Electronic) IS - 0003-9888 (Print) IS - 0003-9888 (Linking) VI - 106 IP - 10 DP - 2021 Oct TI - Perinatal outcomes among births to women with infection during pregnancy. PG - 946-953 LID - 10.1136/archdischild-2021-321865 [doi] AB - OBJECTIVE: This study is part of the Global Maternal Sepsis Study (GLOSS). It aimed to estimate neonatal near-miss (NNM) and perinatal death frequency and maternal risk factors among births to women with infection during pregnancy in low-income and middle-income countries (LMIC). DESIGN: We conducted a 1-week inception hospital-based cohort study. SETTING: The study was carried out in 408 hospitals in 43 LMIC of all the WHO regions in 2017. PATIENTS: We included women with suspected or confirmed infection during pregnancy with at least 28 weeks of gestational age up to day-7 after birth. All babies born to those women were followed from birth until the seventh day after childbirth. Perinatal outcomes were considered at the end of the follow-up. MAIN OUTCOME MEASURES: Perinatal outcomes were (i) babies alive without severe complication, (ii) NNM and (iii) perinatal death (stillbirth and early neonatal death). RESULTS: 1219 births were analysed. Among them, 25.9% (n=316) and 10.1% (n=123) were NNM and perinatal deaths, respectively. After adjustment, maternal pre-existing medical condition (adjusted odds ratios (aOR)=1.5; 95% CI 1.1 to 2.0) and maternal infection suspected or diagnosed during labour (aOR=1.9; 95% CI 1.2 to 3.2) were the independent risk factors of NNM. Maternal pre-existing medical condition (aOR=1.7; 95% CI 1.0 to 2.8), infection-related severe maternal outcome (aOR=3.8; 95% CI 2.0 to 7.1), mother's infection suspected or diagnosed within 24 hours after childbirth (aOR=2.2; 95% CI 1.0 to 4.7) and vaginal birth (aOR=1.8; 95% CI 1.1 to 2.9) were independently associated with increased odds of perinatal death. CONCLUSIONS: Overall, one-third of births were adverse perinatal outcomes. Pre-existing maternal medical conditions and severe infection-related maternal outcomes were the main risk factors of adverse perinatal outcomes. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Baguiya, Adama AU - Baguiya A AUID- ORCID: 0000-0003-1016-4896 AD - Kaya Health and Demographic Surveillance System (Kaya-HDSS), Research Institute of Health Sciences, Ouagadougou, Burkina Faso abaguiya@gmail.com. FAU - Bonet, Mercedes AU - Bonet M AUID- ORCID: 0000-0001-9015-1635 AD - UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland. FAU - Cecatti, Jose Guilherme AU - Cecatti JG AUID- ORCID: 0000-0003-1285-8445 AD - Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, SP, Brazil. FAU - Brizuela, Vanessa AU - Brizuela V AUID- ORCID: 0000-0002-4860-0828 AD - UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland. FAU - Curteanu, Ala AU - Curteanu A AUID- ORCID: 0000-0002-5311-1084 AD - Department of Perinatology, Mother and Child Institute, Chisinau, Moldova. FAU - Minkauskiene, Meile AU - Minkauskiene M AUID- ORCID: 0000-0003-1056-0522 AD - Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania. FAU - Jayaratne, Kapila AU - Jayaratne K AD - Maternal & Child Morbidity & Mortality Surveillance Unit, Family Health Bureau, Colombo, Sri Lanka. FAU - Ribeiro-do-Valle, Carolina Carvalho AU - Ribeiro-do-Valle CC AUID- ORCID: 0000-0002-2630-9909 AD - Department of Obstetrics and Gynecology, School of Medicine, University of Campinas, Rio de Janeiro, Brazil. FAU - Budianu, Mihaela-Alexandra AU - Budianu MA AD - George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Mures, Romania. FAU - Souza, Joao Paulo AU - Souza JP AUID- ORCID: 0000-0002-2288-4244 AD - Department of Social Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil. FAU - Kouanda, Seni AU - Kouanda S AUID- ORCID: 0000-0003-2426-7669 AD - Ecole docotorale ED2ST, Saint Thomas d'Aquin University (USTA), Ouagadougou, Burkina Faso. AD - Biomedical and Public Health Department, Research Institute of Health Sciences, Ouagadougou, Burkina Faso. CN - WHO Global Maternal Sepsis Study (GLOSS) Research Group CN - GLOSS research group LA - eng GR - 001/WHO_/World Health Organization/International PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20210902 PL - England TA - Arch Dis Child JT - Archives of disease in childhood JID - 0372434 SB - IM MH - Adult MH - Comorbidity MH - Developing Countries/*statistics & numerical data MH - Female MH - Gestational Age MH - Humans MH - Infant, Newborn MH - Live Birth/epidemiology MH - Near Miss, Healthcare/*statistics & numerical data MH - Parturition MH - Perinatal Death/etiology MH - *Perinatal Mortality MH - Pregnancy MH - *Pregnancy Complications, Infectious/diagnosis/epidemiology MH - Prospective Studies MH - Risk Factors MH - Stillbirth/*epidemiology MH - Vagina MH - Young Adult PMC - PMC8461398 OTO - NOTNLM OT - epidemiology OT - neonatology COIS- Competing interests: None declared. FIR - Aman, Mohammad Iqbal IR - Aman MI FIR - Noormal, Bashir IR - Noormal B FIR - Diaz, Virginia IR - Diaz V FIR - Espinoza, Marisa IR - Espinoza M FIR - Pasquale, Julia IR - Pasquale J FIR - Leroy, Charlotte IR - Leroy C FIR - Roelens, Kristien IR - Roelens K FIR - Vandenberghe, Griet IR - Vandenberghe G FIR - Christian Agossou, M IR - Christian Agossou M FIR - Keke, Sourou Goufodji IR - Keke SG FIR - Aguemon, Christiane Tshabu IR - Aguemon CT FIR - Peralta, Patricia Soledad IR - Peralta PS FIR - Altamirano, Victor Conde IR - Altamirano VC FIR - Munoz, Rosalinda Hernandez IR - Munoz RH FIR - Batiene, Vincent IR - Batiene V FIR - Cisse, Kadari IR - Cisse K FIR - Ouedraogo, Henri Gautier IR - Ouedraogo HG FIR - Kannitha, Cheang IR - Kannitha C FIR - Phirun, Lam IR - Phirun L FIR - Rathavy, Tung IR - Rathavy T FIR - Simo, Elie IR - Simo E FIR - Tebeu, Pierre-Marie IR - Tebeu PM FIR - Yakana, Emah Irene IR - Yakana EI FIR - Carvajal, Javier IR - Carvajal J FIR - Escobar, Maria Fernanda IR - 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Andal ML FIR - Martin, Carolina Paula IR - Martin CP FIR - Recidoro, Zenaida Dy IR - Recidoro ZD FIR - Puscasiu, Lucian IR - Puscasiu L FIR - Diouf, Leopold IR - Diouf L FIR - Guirassy, Dembo IR - Guirassy D FIR - Moreira, Philippe Marc IR - Moreira PM FIR - Borovsky, Miroslav IR - Borovsky M FIR - Kovac, Ladislav IR - Kovac L FIR - Kristufkova, Alexandra IR - Kristufkova A FIR - Cebekhulu, Sylvia IR - Cebekhulu S FIR - Cornelissen, Laura IR - Cornelissen L FIR - Soma-Pillay, Priya IR - Soma-Pillay P FIR - Cararach, Vicenc IR - Cararach V FIR - Lopez, Marta IR - Lopez M FIR - Benede, Maria Jose IR - Benede MJ FIR - Jayakody, Hemali IR - Jayakody H FIR - Rowel, Dhammica IR - Rowel D FIR - Elsheikh, Mohamed IR - Elsheikh M FIR - Nabag, Wisal IR - Nabag W FIR - Omer, Sara IR - Omer S FIR - Tsoy, Victoria IR - Tsoy V FIR - Uzakova, Urunbish IR - Uzakova U FIR - Yunusova, Dilrabo IR - Yunusova D FIR - Siriwachirachai, Thitiporn IR - Siriwachirachai T FIR - Tangsiriwatthana, Thumwadee IR - Tangsiriwatthana T FIR - Dunlop, Catherine IR - Dunlop C FIR - Knight, Marian IR - Knight M FIR - Lissauer, David IR - Lissauer D FIR - Perez, Aquilino M IR - Perez AM FIR - Roman, Jhon IR - Roman J FIR - Vitureira, Gerardo IR - Vitureira G FIR - Tuan, Dinh Anh IR - Tuan DA FIR - Truong, Luong Ngoc IR - Truong LN FIR - Hanh, Nghiem Thi IR - Hanh NT FIR - Madziyire, Mugove IR - Madziyire M FIR - Magwali, Thulani IR - Magwali T FIR - Munjanja, Stephen IR - Munjanja S FIR - Abalos, Edgardo IR - Abalos E FIR - Chamillard, Monica IR - Chamillard M FIR - Fawole, Bukola IR - Fawole B FIR - Lumbiganon, Pisake IR - Lumbiganon P FIR - Nabhan, Ashraf IR - Nabhan A FIR - Nadisauskiene, Ruta IR - Nadisauskiene R FIR - Bartlett, Linda IR - Bartlett L FIR - Bellissimo-Rodrigues, Fernando IR - Bellissimo-Rodrigues F FIR - Jacob, Shevin T IR - Jacob ST FIR - Shakoor, Sadia IR - Shakoor S FIR - Yunis, Khalid IR - Yunis K FIR - Campodonico, Liana IR - Campodonico L FIR - Cuesta, Cristina IR - Cuesta C FIR - Gamerro, Hugo IR - Gamerro H FIR - Giordano, Daniel IR - Giordano D FIR - Althabe, Fernando IR - Althabe F FIR - Bonet, Mercedes IR - Bonet M FIR - Brizuela, Vanessa IR - Brizuela V FIR - Metin Gulmezoglu, A IR - Metin Gulmezoglu A FIR - Souza, Joao Paulo IR - Souza JP EDAT- 2021/09/04 06:00 MHDA- 2021/11/23 06:00 PMCR- 2021/09/24 CRDT- 2021/09/03 05:57 PHST- 2021/02/15 00:00 [received] PHST- 2021/07/09 00:00 [accepted] PHST- 2021/09/04 06:00 [pubmed] PHST- 2021/11/23 06:00 [medline] PHST- 2021/09/03 05:57 [entrez] PHST- 2021/09/24 00:00 [pmc-release] AID - archdischild-2021-321865 [pii] AID - 10.1136/archdischild-2021-321865 [doi] PST - ppublish SO - Arch Dis Child. 2021 Oct;106(10):946-953. doi: 10.1136/archdischild-2021-321865. Epub 2021 Sep 2.