Is Sequential Organ Failure Assessment Score (SOFA) Valid for Predicting Maternal Outcomes in Pregnancy Associated Sepsis, or Limited to General Population Use?

Abstract

Objective: To assess the prognostic value of the Sequential Organ Failure Assessment score in predicting maternal and neonatal outcomes among women with pregnancy-associated sepsis. Design: A prospective observational study. Subjects/Patients: One hundred antenatal, postnatal, and postabortal women admitted with sepsis were enrolled after informed consent. Methods: The Sequential Organ Failure Assessment score was calculated at admission. The relationship of the score with maternal survival, neonatal admission to intensive care, duration of intensive care stay, and extent of organ dysfunction was evaluated using non-parametric statistical analysis and receiver operating characteristic curve assessment. Results: The mean Sequential Organ Failure Assessment score was significantly higher in women who expired (10.08 ± 3.72) compared to survivors (3.50 ± 3.43, p<0.001). The score showed good diagnostic performance for predicting maternal mortality, with an area under the curve of 0.894. A cutoff value of six predicted death with 89 percent sensitivity and 76 percent specificity. Multi-organ dysfunction involving three or more organs was present in 23 percent of patients and was strongly associated with poor outcome. Higher scores correlated with longer intensive care stay and shorter overall hospital stay. The score demonstrated poor discriminative value for predicting neonatal intensive care admission. Conclusion: The Sequential Organ Failure Assessment score is a valuable tool for maternal risk stratification in pregnancy-associated sepsis, though it lacks predictive accuracy for neonatal outcomes.