RISK-FACTORS IN PUERPERAL ENDOMETRITIS-MYOMETRITIS - AN INCIDENT CASE-REFERENT STUDY

Postpartum endometritis-myometritis (PPEM) was identified in 51 women after vaginal delivery, who were compared with 51 healthy referent par turients, matched for age, parity and days postpartum. Socio-economic background data, past and current obstetric history and clinical data from recent delivery were analyzed. Endocervical and intracavitary cul tures and blood cultures were performed and serological analyses of sy philis and HIV antibodies were carried out. No socio-economic factor s tudied discriminated significantly between cases and referents. Previo us stillbirth (OR 9.44) and previous low-birthweight delivery (OR 3.90 ) occurred significantly more often among cases. In recently past preg nancy preterm delivery (OR 10.07), low birthweight (OR 16.55) and seri ous neonatal morbidity (OR 14.27) were significantly more common among cases. Cases and referents differed also significantly in body mass i ndex <22.5 (OR 3.41), left mid-upper-arm circumference <25 cm (OR 2.66 ), haemoglobin <100 g/l (OR 3.12) and high-risk classification in ante natal care (OR 11.95). Bacterial intracavitary cultures tended to be p ositive and have anaerobes more frequently in cases than in referents. It is concluded that women with PPEM in the setting studied belong to a group at risk also regarding adverse fetal outcome, both in recentl y past and in previous pregnancies.