Rates of Neonatal Sepsis by Maternal Diabetes and Chronic Hypertension [12D

Abstract

INTRODUCTION: The purpose of this study is to characterize the rates of neonatal sepsis among infants born to mothers with diabetes mellitus, gestational diabetes, and chronic hypertension. METHODS: This is a retrospective cohort study of non-anomalous, singleton and twin deliveries in the US. We compared rates of sepsis among infants born to mothers with diabetes mellitus, gestational diabetes, and chronic hypertension to infants born to healthy mothers. Results were analyzed using Pearson Chi-Squared tests to control for maternal race, maternal age, insurance status, education level, diabetes, chronic hypertension, preeclampsia, chorioamnionitis, postpartum hemorrhage, cesarean section, nulliparity, and gestational age. RESULTS: Rates of neonatal sepsis were higher among infants born to mothers with diabetes mellitus and gestational diabetes than among infants born to mothers without diabetes (p<0.001). Diabetes mellitus yielded an odds ratio of 1.31 (95% CI 1.18-1.44) for neonatal sepsis. Gestational diabetes yielded an odds ratio of 1.17 (95% CI 1.12-1.22) for neonatal sepsis. Rates of neonatal sepsis were higher among infants born to mothers with chronic hypertension than among those born to healthy mothers (p<0.001). Chronic hypertension predicted neonatal sepsis with an odds ratio of 1.09 (95% CI 1.00-1.19). CONCLUSION: Infant rates of sepsis increase with maternal diabetes mellitus, gestational diabetes, and chronic hypertension. Maternal diabetes increases risk of neonatal sepsis independent of maternal race, maternal age, insurance status, education level, chronic hypertension, preeclampsia, chorioamnionitis, postpartum hemorrhage, cesarean section, nulliparity, and gestational age. Future research is needed to provide a causative explanation of the relationship between maternal diabetes, chronic hypertension, and neonatal sepsis.