Sepsis in pregnancy and babies

What is sepsis?

Sepsis is a complication of a severe infection. It is when the body’s immune system overreacts to an infection and starts to attack organs and other tissues (NHS, 2022).

Maternal sepsis

When sepsis occurs in pregnant women or birthing people, or within six weeks after giving birth, it’s called maternal or postpartum sepsis. Maternal sepsis is a life-threatening condition (WHO, 2017). Without quick treatment, sepsis can lead to multiple organ failure and death.  

For the period 2021-2023, it was the second most common cause of maternal death in the first six weeks after birth in the UK and Ireland (MBRRACE-UK, 2025).

Sepsis in babies

Babies can also develop sepsis. Babies born premature are more likely to get infections that can lead to sepsis than babies born at term. This is because their immune system is weaker and their skin and gut more fragile (Bliss, no date).

However, babies born at term can also develop sepsis. The most common cause of early onset sepsis (in the first 72 hours after birth) is an infection caused by bacteria known as Group B Streptococcus (Bliss, no date).

Sepsis in babies may also happen when the mother or birthing person’s waters break before labour has started, which is known as Premature Rupture of Membranes (PROM) (Bliss, no date). 

What are the signs of sepsis?

There are lots of possible signs of sepsis and these can be mistaken for other conditions, such as flu or a chest infection. If you or someone you are caring for has signs of sepsis, call 999 or go to A&E (NHS, 2022).

Symptoms in adults can include:  

• acting confused
• slurred speech
• not making sense
• blue, grey or blotchy skin, on darker skin tones this can be easier to see on the palms of the hands or soles of the feet
• a rash that does not fade when a glass is rolled over it
• difficulty breathing, breathlessness or breathing very fast

Some signs of infection and sepsis might be missed due to other pregnancy or postpartum changes in the body (Bonet et al, 2017).

Symptoms in babies include (UK Sepsis Trust, no date):

• breathing very fast
• having a fit or convulsion
• looking mottled, bluish or pale – on darker skin tones, this can be easier to see on the palms of the hands or soles of the feet
• a rash that does not fade when a glass is rolled over it
• being very sleepy or difficult to wake up  

Call 999 or visit A&E if the child has one of the sepsis symptoms and ask medical staff: Could it be sepsis? (UK Sepsis Trust, no date)

What causes sepsis?

An infection in the body can trigger sepsis. Normally, the body responds by sending white blood cells to that area to kill the germs that are causing the infection (NHS Inform, 2022).  

However, an infection can travel to other areas of the body if the immune system is weak or the infection is severe. Widespread inflammation can damage tissue and interfere with blood flow through the body. This can cause blood pressure to become dangerously low, which in turns stops oxygen reaching organs and tissues (NHS Inform, 2022). 

Risk factors for sepsis during pregnancy

Sepsis isn’t contagious and can’t be caught by anyone else (NHS, 2022).

The physical changes during pregnancy make pregnant women and people more likely to get infections. This is especially true in the period after birth (Bonet et al, 2017).

Women and birthing people of Black and Asian backgrounds are at higher risk of developing sepsis (RCOG, 2024).

Risk factors for developing sepsis during birth or afterwards include (RCOG, 2024):

• if the woman or birthing person has experienced their waters breaking over a long period of time
• caesarean birth
• carrying twins or multiples
• Group B strep 

What is the treatment for sepsis?

Sepsis requires treatment in hospital straight away because it can get worse quickly (NHS, 2022).

Antibiotics are the main treatment for sepsis. Ideally, antibiotic treatment should start within an hour of diagnosis (NHS Inform, 2022).

The antibiotics will be given through a vein for the first two to four days. After this, medication will be taken orally (by mouth) for 7-10 days, depending on how severe the infection is (NHS Inform, 2022). 

How can the chance of developing sepsis be reduced?

Sepsis can't be prevented, but the risk can be reduced.  

The risk of maternal sepsis can be reduced by practising good hygiene, for example washing hands before and after touching a sanitary pad or using the toilet (UK Sepsis Trust, no date).

Pregnant women and people have a higher chance of developing sepsis from other sources, including influenza. This is one of the reasons why the flu vaccine is recommended in pregnancy (UK Sepsis Trust, no date). 

Can maternal sepsis affect the birth or baby?

If a pregnant woman or birthing person is ill with sepsis, then bringing forward the birth of the baby may be considered. If it is likely that a baby would need to be born early, the mother or birthing person might receive steroid injections to prepare the baby’s lungs for birth (RCOG, 2024).

There would be continuous monitoring of the baby’s heart rate and the mother or birthing person’s temperature during the birth (RCOG, 2024).

The infection which caused sepsis could pass from the mother or birthing person to the baby before, during or after birth, which is why there is additional monitoring for the baby during labour. Depending on the type of infection, antibiotics might be offered to the baby after birth to prevent them catching the infection (RCOG, 2024). 

What are the long term effects of sepsis?

Most people make a full recovery with the right treatment, but it can take time.

Long term effects of sepsis include:

• feeling tired
• difficulty sleeping
• loss of appetite
• changes in mood
• anxiety or depression 

Help and information can be found from the UK Sepsis Trust. If you have any concerns, speak to a healthcare professional urgently.