Epidemiology, comorbidity patterns and outcomes of maternal sepsis-related coded discharges in Ireland 2020-2025.

BACKGROUND

Maternal sepsis remains a leading cause of maternal morbidity and mortality globally. National data on maternal sepsis are limited in Ireland.

METHODS

We conducted a retrospective analysis of the Hospital In-Patient Enquiry (HIPE) database, including all sepsis-related coded hospital discharges from 1 January 2020 to 31 December 2025. Episodes were classified as hospital-onset or community-onset according to whether the associated infection diagnosis was coded as hospital-acquired. Maternal episodes were defined as episodes occurring in individuals from conception to six weeks postpartum. Infection sources and comorbidities were identified using ICD coding and a validated maternal comorbidity index. Univariable logistic regression was used to examine factors associated with critical care admission.

RESULTS

Among 80,628 sepsis admissions, 2.0% (n = 1645) were maternal. Of them, 73.6% (n = 1,211) were community-onset. Compared to community-onset episodes, hospital-onset episodes were associated with higher rates of critical care admission (22.6% versus 10.4%, p < 0.001). One death was reported among hospital-onset episodes. Among community-onset episodes, presence of one or more underlying comorbidities was strongly associated with critical care admission (adjOR 3.27, 95% CI 2.12-5.07, p < 0.001).

CONCLUSIONS

Maternal sepsis in Ireland is uncommon and associated with low in-hospital mortality but notable critical care admission. Respiratory infections are the major determinants of critical care admission. These findings support continued emphasis on early recognition and risk stratification in maternity care, aligned with national maternity sepsis guidelines and the Irish Maternity Early Warning System for secondary care.