Maternal factors independently associated with neonatal near-miss and perinatal death from women with infection during pregnancy
| Variable | Neonatal near-miss (n=316) | Perinatal death (n=123) | ||||
| aOR | 95% CI | p value | aOR | 95% CI | p value | |
| Maternal pre-existing condition* | ||||||
| None | ref | ref | ||||
| Any pre-existing condition | 1.5 | 1.1 to 2.0 | 0.023† | 1.7 | 1.0 to 2.8 | 0.041† |
| Severity of maternal infection‡‡ | ||||||
| Less severe infection | ref | ref | ||||
| Infections with complication | 0.9 | 0.6 to 1.4 | 0.716 | 1.0 | 0.5 to 1.9 | 0.904 |
| Infection-related severe maternal outcome | 1.5 | 0.9 to 2.4 | 0.099 | 3.8 | 2.0 to 7.1 | <0.001† |
| Pregnancy status at the time of infection suspected or confirmed | ||||||
| Pregnant not in labour | 1.5 | 0.9 to 2.6 | 0.100 | 1.7 | 0.8 to 3.8 | 0.199 |
| Pregnant in labour | 1.9 | 1.2 to 3.2 | 0.011† | 1.2 | 0.5 to 2.9 | 0.610 |
| Postpartum within 24 hours | 1.5 | 0.9 to 2.5 | 0.136 | 2.2 | 1.0 to 4.7 | 0.045† |
| Postpartum 24–72 hours | 1.0 | 0.6 to 1.7 | 0.964 | 0.9 | 0.4 to 2.7 | 0.905 |
| Postpartum more than 72 hours | ref | ref | ||||
| Other obstetric complications | ||||||
| None | ref | ref | ||||
| Any complication | 1.3 | 0.9 to 1.8 | 0.104 | 1.7 | 1.0 to 2.8 | 0.055 |
| The final mode of birth | ||||||
| Vaginal (spontaneous/instrumental) | 0.9 | 0.7 to 1.2 | 0.461 | 1.8 | 1.1 to 2.9 | 0.022† |
| C-section | ref | ref | ||||
Random effect: country-level variance of the variance component model: 0.3 with 95% CI (0.1 to 0.6) and an intraclass correlation coefficientof 13%.
Random effect: country-level variance of the final model: 0.6 with 95% CI (0.3 to 1.2) with an intraclass correlation coefficient of 20%.
*Includes anaemia, diabetes, HIV or any disease that required corticotherapy, chemotherapy, immunotherapy or transfusion during the pregnancy.
†Statistically significant (p<0.05).
‡Infections with complications include an invasive procedure to treat the source of infection (vacuum aspiration, dilatation and curettage, wound debridement, drainage (incision, percutaneous, culdotomy) laparotomy, lavage and other surgery), admission to intensive care or high dependency unit or transfer to another facility. Severe maternal outcome defined as infection-related maternal death or near-miss
aOR, adjusted OR for country-level clustering (level 2 in the model), with the country and hospital-level factors (country income level, hospital level of care and number of births in 2016) in the multilevel multinomial logistic regression model.; ICC, intraclass correlation coefficient .