ArticleMaternal health, neonatology and perinatology2025
Association of Kaiser sepsis score with confirmed intrauterine infection and inflammation (Triple-I) in clinical chorioamnionitis: a retrospective cohort study.
Article in Maternal health, neonatology and perinatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChorioamnionitis is a known independent risk factor for early-onset sepsis (EOS) in infants. In 2015, the term was redefined as "intrauterine inflammation or infection or both" (Triple-I) to improve clinical management of maternal and neonatal infections. This study evaluated the association between the Kaiser sepsis score (KSS), a tool for predicting and managing EOS in newborns, and histopathologic chorioamnionitis (HCA) and confirmed Triple-I.
methodsThis retrospective cohort study included mother-infant dyads with a gestational age of ≥ 34 weeks at birth, delivered between January 2014 and December 2019, with a maternal diagnosis of clinical chorioamnionitis. Receiver operating characteristic (ROC) curves were used to assess the association between the KSS, Triple-I, and HCA.
resultsA total of 230 mother-infant dyads were analyzed, of whom 157 (68.2%) had HCA and 86 (37.3%) had confirmed Triple-I. Infant demographic characteristics were comparable between groups, except for the KSS, which was significantly higher in the Triple-I group [1.22 vs. 0.83, p < 0.001; OR 1.21, 95% CI 1.04-1.4]. The KSS demonstrated a strong positive association with confirmed Triple-I (AUC 0.77, 95% CI 0.71-0.83), while its association with HCA was weaker (AUC 0.59, 95% CI 0.51-0.67). At the same KSS threshold, sensitivity for diagnosing Triple-I was higher than for HCA.
conclusionKSS showed a stronger association with confirmed Triple-I compared to HCA in mothers with clinical chorioamnionitis, suggesting that Triple-I is a better predictor of EOS risk.
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