Women in the UK are facing increasing risks from serious blood infections, experts warn today.
Maternal death from sepsis is increasing, explains Professor Marian Knight of Oxford University, UK, and is now the top cause of direct maternal death in the UK. This trend is mostly because of a rising number of cases of group A streptococcal infection.
In the journal PLoS Medicine, Professor Knight and her team write that "an increase in maternal mortality implies a greater number of women with severe, life-threatening illness".
Their study included 365 confirmed cases of severe maternal sepsis and compared them with 757 similar unaffected women from all over the UK. The sepsis rate was 4.7 per 10,000 pregnancies. Among sepsis patients, 19.5% developed septic shock and 1.4% died.
The risk was higher for black or other ethnic minority women, first-time mothers, those with a pre-existing medical problem, and those having caesarean. Among those who developed sepsis, risk of septic shock was higher for multiple pregnancies and those infected with group A streptococcus.
"For each maternal sepsis death, approximately 50 women have life-threatening morbidity from sepsis," state the authors. "Follow-up to ensure infection is eradicated is important, as antibiotic prescription does not necessarily prevent progression to severe sepsis."
They add that the rapid progression to severe sepsis "highlights the importance of following the international Surviving Sepsis Campaign guideline of early administration of high-dose intravenous antibiotics."
Finally, they warn that signs of severe sepsis in women shortly before or after labour, particularly with confirmed or suspected group A streptococcal infection, "should be regarded as an obstetric emergency".
Acosta, C. D. et al. Severe Maternal Sepsis in the UK, 2011: A National Case-Control Study. PLoS Medicine 9 July 2014 doi:10.1371/journal.pmed.1001672 [abstract]
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