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Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): A 1-week inception cohort study

The Lancet Global Health May 01, 2020

The WHO Global Maternal Sepsis Study (GLOSS) Research Group, et al. - Researchers aimed at inscribing the main findings of the WHO Global Maternal Sepsis Study, which was performed to determine the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. A facility-based, prospective, 1-week inception cohort study was conducted in 713 health facilities that provide obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, postpartum, or postabortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). From Nov 28, 2017, to Dec 4, 2017, they assessed 2,965 women for eligibility. Of these, they included 2,850 pregnant or recently pregnant women with suspected or confirmed infection. A maternal infection was reported in 70·4 (95% CI 67·7–73·1) hospitalized women per 1,000 livebirths, and infection-related (underlying or contributing cause) severe maternal outcomes were reported in 10·9 (9·8–12·0) women per 1,000 livebirths. This indicates a high frequency of maternal infections requiring management in health facilities. Relative to previous assumptions, greater contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths was reported in this work. Findings emphasize the urgent necessity for improvement of early identification, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices.

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