Maternal Sepsis Epidemiology and Management

Maternal sepsis remains a leading cause of pregnancy-related mortality and severe morbidity globally. Defined as a life-threatening organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion or the postpartum period, it complicates an estimated 0.05–0.5% of deliveries in high-income settings and a substantially higher proportion in low-resource regions. Both obstetric and non-obstetric pathogens, notably Escherichia coli and Group A Streptococcus, contribute to invasive disease, while antimicrobial resistance is emerging as a major obstacle to effective therapy. Risk factors include operative delivery, prolonged labour, multiple vaginal examinations and underlying conditions such as diabetes or anaemia. Timely recognition—through monitoring of vital signs and organ function—paired with early administration of broad-spectrum antibiotics and appropriate source control, underpins current management guidelines. However, substantial gaps remain in diagnostic coding, adherence to antimicrobial guidelines and resource allocation, particularly in low- and middle-income countries, emphasising the need for standardised surveillance and quality improvement initiatives across diverse healthcare settings.

Research from Nature Portfolio

A hospital-based retrospective cohort study in a Nordic setting has provided new estimates of obstetric infection and maternal sepsis incidence among pregnant, labouring and postpartum women. The investigators observed an overall infection rate of 7.8% and a maternal sepsis incidence of 0.3%, most cases arising in the postpartum period. Management quality varied substantially: while two-thirds of women received prompt broad-spectrum antibiotics on diagnosis, fewer than one in six with puerperal sepsis were treated according to national antimicrobial guidelines. Diagnostic coding proved inadequate, with obstetric infection codes capturing only one-fifth of true sepsis cases. These findings underline the importance of improving both clinical pathways and administrative coding systems to ensure accurate surveillance and timely, guideline-adherent care.

Maternal Sepsis Epidemiology and Management publication trend

The graph below shows the total number of articles in maternal sepsis epidemiology and management across all publications each year (not limited to Nature Index journals).

Technical terms

Maternal sepsis: Life-threatening organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion or postpartum.

Puerperal sepsis: Infection of the genital tract occurring up to 42 days after childbirth or abortion, often involving systemic inflammation.

Incidence: The number of new disease cases in a defined population over a specific period.

Nomogram: A graphical calculator that integrates multiple predictive factors to estimate the probability of a clinical event.

Antimicrobial resistance: The ability of microorganisms to survive exposure to drugs designed to kill or inhibit them, reducing therapeutic options.

References

1. Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation. Reproductive Health (2017).
2. Obstetric infections and clinical characteristics of maternal sepsis: a hospital-based retrospective cohort study. Scientific Reports (2024).
3. A simple predictive model for puerperal infections: emphasizing risk factors and pathogen analysis. Frontiers in Cellular and Infection Microbiology (2024).
4. Evaluation of microbiological epidemiology and clinical characteristics of maternal bloodstream infection: a 10 years retrospective study. Frontiers in Microbiology (2024).
5. Trends and disparities of disease burden in infections among pregnant women in 131 low-income and middle-income countries, 1990-2019.. Journal of Global Health (2024).