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Infectious Diseases in Obstetrics and Gynecology
Volume 2013 (2013), Article ID 124102, 6 pages
http://dx.doi.org/10.1155/2013/124102
Research Article

Medical and Infectious Complications Associated with Pyelonephritis among Pregnant Women at Delivery

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University, DUMC Box 3967, Durham, NC 27710, USA

Received 25 April 2013; Revised 23 August 2013; Accepted 26 August 2013

Academic Editor: Lu-Yu Hwang

Copyright © 2013 Sarah K. Dotters-Katz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 2008–2010. 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 2008–2010, 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.