%0 Journal Article
%T Medical and Infectious Complications Associated with Pyelonephritis among Pregnant Women at Delivery
%A Sarah K. Dotters-Katz
%A R. Phillips Heine
%A Chad A. Grotegut
%J Infectious Diseases in Obstetrics and Gynecology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/124102
%X Objective. Pyelonephritis is a common cause of antepartum admission and maternal morbidity. Medical complications associated with pyelonephritis during delivery are not well described; thus the objective of this study was to estimate medical, infectious, and obstetric complications associated with pyelonephritis during the delivery admission. Study Design. We conducted a retrospective cohort study using the Nationwide Inpatient Sample (NIS) for the years 2008每2010. The NIS was queried for all delivery-related discharges. During the delivery admission, the ICD-9-CM codes for pyelonephritis were used to identify cases and were compared to women without pyelonephritis. A multivariable logistic regression model was constructed for various medical, infectious, and obstetric complications among women with pyelonephritis compared to women without, while controlling for preexisting medical conditions and demographics. Results. During the years 2008每2010, there were 26,397 records with a diagnosis of pyelonephritis during the delivery admission, for a rate of 2.1 per 1000 deliveries. Women with pyelonephritis had increased associated risks for transfusion, need for mechanical ventilation, acute heart failure, pneumonia, pulmonary edema, acute respiratory distress syndrome, sepsis, acute renal failure, preterm labor, and chorioamnionitis, while controlling for preexisting medical conditions. Conclusions. Pyelonephritis at delivery admissions is associated with significant medical and infectious morbidity. 1. Introduction Pyelonephritis during pregnancy has the potential to cause serious morbidity to the pregnant woman. It is the most common nonobstetric indication for antepartum hospitalization, and its associated risk factors, diagnosis, and management in the antepartum period are well described [1每4]. Serious morbidity associated with pyelonephritis in pregnancy is common. Sepsis and septic shock occur secondary to pyelonephritis more frequently than secondary to any other infectious process during pregnancy [5]. Acute respiratory distress syndrome complicates approximately 1每8.5% of pyelonephritis cases [6, 7]. Frequently, an admission to an intensive care unit is necessary. While the implications of pyelonephritis in the antepartum period are well described, there is little data about outcomes and complications when pyelonephritis occurs at the time of delivery [1每3, 8每11]. As these studies describe outcomes of pregnancies complicated by pyelonephritis, none of these describe specifically outcomes of patients who deliver during the admission during which they
%U http://www.hindawi.com/journals/idog/2013/124102/