{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:08:36Z","timestamp":1792789716873,"version":"4.5.0"},"reference-count":48,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T00:00:00Z","timestamp":1672444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Maternal sepsis represents a leading cause of mortality and severe morbidity worldwide. In Italy, it is the second cause of direct maternal mortality. Delay in recognition and treatment initiation are the drivers of sepsis-associated adverse outcomes. Between November 2017 and October 2019, the Italian Obstetric Surveillance System coordinated a prospective population-based study on maternal sepsis occurring before or after childbirth from 22 weeks\u2019 gestation onward and up to 42 days following the end of pregnancy. A nested 1:2 matched case-control study on postpartum sepsis was also performed. Maternal sepsis was diagnosed for the presence of suspected or confirmed infection alongside signs or symptoms of organ failure. The aim of this study was to assess maternal sepsis incidence and its associated risk factors, management, and perinatal outcomes. Six Italian regions, covering 48.2% of the national births, participated in the project. We identified an incidence rate of 5.5 per 10,000 maternities (95% CI 4.80\u20136.28). Seventy percent of patients had a low education level and one third were foreigners with a language barrier. Genital, respiratory, and urinary tract infections were the predominant sources of infection; the majority of cases was caused by E. coli and polymicrobial infections. The presence of vascular and indwelling bladder catheters was associated with a nine-fold increased risk of postpartum sepsis. There were no maternal deaths, but one fourth of women experienced a serious adverse event and 28.3% required intensive care; 1.8% of newborns died. Targeted interventions to increase awareness of maternal sepsis and its risk factors and management should be promoted.<\/jats:p>","DOI":"10.3390\/microorganisms11010105","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T02:12:48Z","timestamp":1672625568000},"page":"105","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Maternal Sepsis in Italy: A Prospective, Population-Based Cohort and Nested Case-Control Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Sara","family":"Ornaghi","sequence":"first","affiliation":[{"name":"Department of Obstetrics, MBBM Foundation Onlus at San Gerardo Hospital, 20900 Monza, Italy"},{"name":"School of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Maraschini","sequence":"additional","affiliation":[{"name":"Technical-Scientific Statistical Service, Istituto Superiore di Sanit\u00e0\u2014Italian National Institute of Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Buoncristiano","sequence":"additional","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanit\u00e0\u2014Italian National Institute of Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1337-2666","authenticated-orcid":false,"given":"Edoardo","family":"Corsi Decenti","sequence":"additional","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanit\u00e0\u2014Italian National Institute of Health, 00161 Rome, Italy"},{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Colciago","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9217-3034","authenticated-orcid":false,"given":"Irene","family":"Cetin","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Department of Obstetrics and Gynecology, V. Buzzi Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-2072","authenticated-orcid":false,"given":"Serena","family":"Donati","sequence":"additional","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanit\u00e0\u2014Italian National Institute of Health, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the ItOSS-Regional Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"h4255","DOI":"10.1136\/bmj.h4255","article-title":"Ending preventable maternal and newborn mortality and stillbirths","volume":"351","author":"Chou","year":"2015","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: A WHO systematic analysis","volume":"2","author":"Say","year":"2014","journal-title":"Lancet Glob. 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