Their findings showed that childbirth complications are more likely to occur when women contract severe infections during pregnancy. They explained that when infections develop into sepsis and women need to be admitted to the hospital, there is a greater likelihood of childbirth risks.
“All the prior studies only looked at sepsis and delivery during the same admission, so delivery right after sepsis,” said researcher Dr. Stephanie Gaw. “But with the majority of sepsis cases that happen during pregnancy, the moms are treated with antibiotics or other medications and they get better. Nobody had looked at what happens to moms that are really sick at some point during their pregnancy, recover from that acute episode, and go home. Do they go on to have normal pregnancies? Do the babies do okay?”
Identifying health risks
For the study, the researchers analyzed data from nearly 15,000 women who delivered at UCSF over a six-year period; nearly 60 women were admitted into the hospital with a septic infection over the course of their pregnancies. The team followed the women’s health outcomes from their pregnancies through delivery.
Ultimately, the researchers learned that women who had experienced severe infections during pregnancy were two times as likely to also experience complications during childbirth. Women that contracted septic infections during pregnancy tended to have higher BMIs, were younger, and were more likely to also have pregestational diabetes. The study showed that urinary tract infections were the most common type of infection among the women who were hospitalized.
“If pregnant women were admitted for severe infection, even after they’re discharged and they recover from that infection, there was an increased risk of complications related to pregnancy that are associated with core placental dysfunction,” said Dr. Gaw.
The three biggest risks during childbirth following a septic infection during pregnancy were placenta dysfunction, hypertensive disease of pregnancy, and small birth weight. However, there was also a higher risk of stillbirth and C-section deliveries.
“Having a baby that was small for gestational age was more common if you had sepsis during pregnancy than if you didn’t, even after controlling for other risk factors,” Dr. Gaw said. “One thing that could be changed in current prenatal care practice would be to add another ultrasound to monitor the baby’s growth. In the third trimester, that was not routinely done for all of these patients and isn’t routinely done in clinical practice right now.”
Moving forward, the researchers hope the medical community continues to work toward improvements in this area so that pregnant women can deliver their children safely and without complications.
“We need more data to identify potential interventions -- whether a woman gets malaria, COVID, or any other type of infection -- to slow the inflammatory process, so that these long-term, permanent changes to the placenta don’t happen,” Dr. Gaw said.