Incidence of morbidity and mortality related to sepsis and risk factors associated with its development during pregnancy, childbirth and the postpartum period in State of Santa Catarina. Carmem Regina Delziovo, Health Department of Santa Catarina State, carmemdelziovo@hotmail. com Mara Martins Conceição, Health Department of Santa Catarina State, maramartins@saude. sc. gov. br Rita de Cassia Teixeira Rangel, University of Itajaí Valley, Itajaí, SC, Federal University of Santa Catarina, Florianópolis, SC, rctrangel@gmail. com Anna Carolina Raduenz Huf Souza, Federal University of Santa Catarina, Florianópolis, SC, acrhuf@gmail. com INTRODUCTION OBJECTIVE The State of Santa Catarina is located in the South of Brazil and divided in 295 municipalities and 16 Health Regions. The population is 6, 383, 286 inhabitants, and 43, 78% of the female population women in reproductive age. The Health Care Network has 1533 Family Health Strategy teams, 217 Family Health Support Centers and 85 Psychosocial Care Centers, covering 75, 2% of population. Has 207 hospitals, where 18 are reference to high risk childbirth in Stork Network, and 60% of births are registered in the Hospital Information System, on average 60, 000/year. Maternal sepsis is considered a relatively rare complication of pregnancy, childbirth and postpartum, nevertheless it is one of the five leading causes of maternal mortality worldwide (1). The morbidity related to sepsis and mortality during pregnancy, however, are underestimated, especially during labor. Therefore the aim of this study is estimate the incidence rate of morbidity and mortality related to sepsis, the risk factors associated with its development during pregnancy, childbirth and the postpartum period in State of Santa Catarina. CONTRIBUTIONS EXPECTATIONS It will be performed a retrospective cohort study using records from the Hospital Information System, Mortality Information System and Live Birth Information System of Santa Catarina, database from 2006 to 2015. Women with and without sepsis will be characterized demographically by: age (<25, 25 -34, ≥ 35 years), race (white, black, other) and smoking (yes, no); clinical conditions: to be identified by ICD-10 codes and classified by three periods of specific maternity time: early pregnancy (diabetes mellitus, cardiovascular disease, hypertension, obesity), late pregnancy (gestational diabetes, pre-eclampsia, placental abruption, preterm, premature rupture of membranes), childbirth/postpartum (premature labor, premature rupture of membranes, post-term pregnancy, vaginal spontaneous delivery, instrumental delivery, cesarean section, peripartum hysterectomy, postpartum hemorrhage, blood transfusion, chorioamnionitis, puerperal infection). Patients who died of sepsis will be described similarly(1). It is expected conduct this research project in partnership with researchers from the United Kingdom in order to identify risk factors associated with puerperal infection once this is a major cause of maternal morbidity and mortality in the country. Thus also extends up the researchers´ knowledge on this topic and qualify the products of this study, powering the reduction of morbidity and mortality from preventable causes. Multivariate logistic regression will be used to estimate odds ratio (OR) and confidence interval of 95%, describing the associations between demographic characteristics of pregnant, clinical conditions and the risk of maternal sepsis and maternal mortality related to sepsis. The study intends to highlight the demographic characteristics and clinical conditions, pre-existing or developing during pregnancy or after childbirth wich can identify pregnant women with risk to develop sepsis or die of sepsis. Sepsis during pregnancy and postpartum period is a potentially preventable condition and it is known that there are high-risk groups more likely to develop sepsis, therefore the surveillance of women is justified in Women's Health Care Network in Santa Catarina. Studies indicate the importance of researching these high-risk groups, vital step in reducing maternal sepsis mortality rate and improving obstetric care quality (1). REFERENCE 1 - Ghassan Al-Ostad, et al. Incidence and risk factors of sepsis mortality in labor, delivery and after birth: Population-based study in the USA. Journal of Obstetrics &Gynaecology Research, Malden, Massachusetts, v. 41, n. 8, p. 1201 -1206 6 p, 2015. ISSN 1341 -8076. Disponível em: <http: //search. ebscohost. com/login. aspx? direct=true&db=c 8 h&AN=1085 93656〈 =pt-br&site=ehost-live&authtype=ip, cookie, uid 2 - Acosta, C. et al. Maternal sepsis: a Scottish population-based casecontrol study. BJOG: An International Journal of Obstetrics &Gynaecology, Malden, Massachusetts, v. 119, n. 4, p. 474 -483 10 p, 2012. ISSN 1470 -0328. Disponível em: <http: //search. ebscohost. com/login. aspx? direct=true&db=c 8 h&AN=1045 18197〈 =pt-br&site=ehost-live&authtype=ip, cookie, uid>. 3 - Maharaj D. Puerperal pyrexia: a review. Part I. Obstet. Gynecol. Surv 2007; 62: 393– 399. 4 - Maharaj D. Puerperal pyrexia: a review. Part II. Obstet. Gynecol. Surv 2007; 62: 400– 406. 5 -Souza, JP. Mortalidade materna no Brasil: a necessidade de fortalecer os sistemas de saúde. Rev. Bras. Ginecol Obstet. 2011; 33(10): 273 -9 6 -Laurenti R, Jorge MH, Gotlieb SL. A mortalidade materna nas capitais brasileiras: algumas características e estimativa de um fator de ajuste. Rev. Bras. Epidemiol 2004; 7: 449 -60. 7 -Pfitscher LC et al. The role of infection and sepsis in the Brazilian Network for Surveillance of Severe Maternal Morbidity. TM & IH. Tropical Medicine and Internaconal Health (Print), v. 21, p. 183 -193, 2016. 8 -Martins HEL, Souza ML, Arzuaga-Salazar MA. Maternal mortality from hemorrhage in the State of Santa Catarina, Brazil. Rev. esc. enferm. USP [Internet]. 2013 Oct [cited 2016 Feb 24] ; 47( 5 ): 1025 -1030. Available from: hip: // www. scielo. br/scielo. hip: //dx. doi. org/10. 1590/S 0080 -623420130000500003
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