{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:37:52Z","timestamp":1772555872534,"version":"3.50.1"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The California Maternal Quality Care Collaborative (CMQCC) developed a pregnancy-adjusted sepsis screen that includes temperature \u2265100.4\u00b0F, heart rate\u2009&gt;\u2009110\u2009bpm, respiratory rate\u2009&gt;\u200924\u2009bpm, and white blood cell count\u2009&gt;\u200915,000\/mm3. This tool was not validated in the intrapartum state. We aim to evaluate the performance of the first part of the CMQCC sepsis screen to identify infection-related morbidity in patients diagnosed with intraamniotic infection.<\/jats:p><jats:p>A retrospective cohort study was performed of 541 patients diagnosed with suspected intraamniotic infection prior to delivery at a single center from July 2017 to June 2021. The primary outcome was composite maternal infectious morbidity (end-organ injury, bacteremia, intensive care unit admission, postpartum endometritis, postpartum readmission for infection, or maternal death) in birthing people who screened positive (two or more CMQCC sepsis screen criteria) compared with those who screened negative. Binary logistic multivariable regression was performed with backward selection including overall sepsis screen results as well as individual screening criteria. Data presented as odds ratio (OR) with a two-sided p-value of 0.05 was used for significance.<\/jats:p><jats:p>Of the 541 reviewed cases, 336 (62%) screened positive while 205 (38%) screened negative. Birthing people with a positive sepsis screen in labor had a higher rate of composite maternal infectious morbidity compared with those with a negative screen, although this did not reach statistical significance (17.6% vs. 11.7%; p\u2009=\u20090.07; OR: 1.6 [0.96\u20132.68]). In evaluating individual criteria, heart rate\u2009&gt;\u2009110\u2009bpm (p\u2009=\u20090.003; OR: 2.1 [1.3\u20133.4]) and respiratory rate\u2009&gt;\u200924\u2009bpm (p\u2009=\u20090.039; 5.7 [1.09\u201329.8]) were significantly associated with composite maternal infectious morbidity.<\/jats:p><jats:p>Most birthing people with intraamniotic infection screen positive prior to delivery using the CMQCC sepsis screen. When looking at the sepsis screen's individual components, elevated heart rate and respiratory rate may be useful in identifying those at increased risk of infectious morbidity.<\/jats:p>","DOI":"10.1055\/a-2599-4813","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T18:36:34Z","timestamp":1748025394000},"page":"1793-1797","source":"Crossref","is-referenced-by-count":1,"title":["Association of Pregnancy-Adjusted Sepsis Screening Criteria with Risk of Maternal Infectious Morbidity in the Setting of Intrapartum Intraamniotic Infection"],"prefix":"10.1055","volume":"42","author":[{"given":"Kathryn","family":"Ruymann","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eshika","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martinique","family":"Ogle","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huda B.","family":"Al-Kouatly","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupsa C.","family":"Boelig","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/AOG.0000000000002114","article-title":"Pregnancy-related mortality in the United States, 2011-2013","volume":"130","author":"A A Creanga","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"e1001672","DOI":"10.1371\/journal.pmed.1001672","article-title":"Severe maternal sepsis in the UK, 2011-2012: a national case-control study","volume":"11","author":"C D Acosta","year":"2014","journal-title":"PLoS Med"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ajog.2004.03.003","article-title":"The maternal-fetal medicine units cesarean registry: chorioamnionitis at term and its duration-relationship to outcomes","volume":"191","author":"D J Rouse","year":"2004","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref4","first-page":"59","article-title":"Term maternal and neonatal complications of acute chorioamnionitis","volume":"66","author":"J C Hauth","year":"1985","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1097\/AOG.0000000000001028","article-title":"Maternal deaths due to sepsis in the state of Michigan, 1999\u20132006","volume":"126","author":"M E Bauer","year":"2015","journal-title":"Obstet Gynecol"},{"issue":"11","key":"ref7","doi-asserted-by":"crossref","first-page":"e1063","DOI":"10.1097\/CCM.0000000000005337","article-title":"Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021","volume":"49","author":"L Evans","year":"2021","journal-title":"Crit Care Med"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for sepsis and septic shock (Sepsis-3)","volume":"315","author":"M Singer","year":"2016","journal-title":"JAMA"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1097\/AOG.0000000000000423","article-title":"Maternal physiologic parameters in relationship to systemic inflammatory response syndrome criteria: a systematic review and meta-analysis","volume":"124","author":"M E Bauer","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/AOG.0000000000005480","article-title":"Performance characteristics of sepsis screening tools during antepartum and postpartum admissions","volume":"143","author":"M E Bauer","year":"2024","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/AOG.0000000000005477","article-title":"Performance characteristics of sepsis screening tools during delivery admissions","volume":"143","author":"E K Main","year":"2024","journal-title":"Obstet Gynecol"},{"key":"ref12","volume-title":"Improving Diagnosis and Treatment of Maternal Sepsis: A Quality Improvement Toolkit","author":"R Gibbs"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"e95","DOI":"10.1097\/AOG.0000000000002236","article-title":"Committee opinion no. 712: intrapartum management of intraamniotic infection","volume":"130","author":"Committee Opinion No","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"12","key":"ref14","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","article-title":"A simulation study of the number of events per variable in logistic regression analysis","volume":"49","author":"P Peduzzi","year":"1996","journal-title":"J Clin Epidemiol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2599-4813.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T22:37:34Z","timestamp":1759271854000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2599-4813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":13,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,9,30]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2599-4813","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]}}}