Abstract

GOMEZ, Pio Iván  and  GAITAN, Hernando Guillermo. Association between pregnancy-induced hypertension and post-partum infection in the Instituto Materno Infantil, Bogotá, Colombia: case control study. Rev Colomb Obstet Ginecol [online]. 2004, vol.55, n.3, pp.193-200. ISSN 0034-7434.

Introduction. Post-partum infection is one of the main causes of maternal morbidity-mortality in developing countries. Identifying factors predisposing to infection will allow intervention for preventing them or (if they cannot be prevented) using other means for reducing their impact. Toxaemia seems to increase the risk of infection developing due to alterations in cell and humoral immunity. The present work’s object is to evaluate whether patients having preeclampsia have a greater risk of presenting post-partum infection. Materials and Methods. A matched case control study was carried out. Pairing by day of birth was done. Inclusion criteria: women giving birth in the Instituto Materno Infantil aged between 15 and 45. Exclusion criteria: clinical patients having infection on being admitted, immunosuppression, second stage of delivery greater than two hours, antibiotic-therapy one week before birth, post-partum eclampsia. Sample size: 95% level of confidence, 80% power, 1:1 ratio, 8% frequency of controls’ exposure, estimated OR 2. It was determined that 369 patients would be required per group. The two groups were compared by using t student test paired or Wilcoxon signed ranks test (according to normality in continuous variables) and McNemar’s test for percentages. Bivariable analysis was done on stratifying by birth route. Crude and adjusted OR were estimated for controlling confounders using conditional logistical regression.Results. The risk of infection was increased in mild preeclampsia (OR 8.28, 95%CI 2.04-33.5) and severe preeclampsia (OR 9.42, 95%CI 2.10-41.3). The risk of infection was also increased in adolescents (OR 3.87, 95%CI 1.75 - 8.54) and who underwent caesarean section (OR 8.17, 95%CI 2.71 - 24.62). Conclusions. Using prophylactic antibiotics must be evaluated in vaginal birth and alternatives should be evaluated in terms of duration and currently considered first-choice antibiotic schemes for prophylaxis in caesarean section in patients suffering from preeclampsia.

Keywords : Pre-Eclampsia; Puerperal infection; Case control studies; Risk factors.

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