title: Medical and infectious complications associated with pyelonephritis among pregnant women at delivery.
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.
  
  
  METHODS
  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.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University, DUMC Box 3967, Durham, NC 27710, USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Dotters-Katz
authors.forename: R Phillips
authors.initials: RP
authors.lastname: Heine
authors.forename: Chad A
authors.initials: CA
authors.lastname: Grotegut
mesh_terms: D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases; D016015:Logistic Models; D007744:Obstetric Labor Complications / Q000209:etiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011704:Pyelonephritis / Q000150:complications*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult