Low Rate of Perinatal Sepsis in Term Infants of Mothers with Chorioamnionitis
Low Rate of Perinatal Sepsis in Term Infants of Mothers with Chorioamnionitis
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DOI：
10.1055/s-0035-1560045
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发表时间：
2016-01-01
影响因子：
2
通讯作者：
Getahun, Darios
中科院分区：
文献类型：
--
作者：
Braun, David;Bromberger, Patricia;Getahun, Darios
目的绒毛膜炎（CAM）母亲的婴儿感染的风险可能低于以前的报道。本研究的目的是确定产时发热（IPF）和培养阳性早发性新生儿细菌感染（CPEOI）在有或无CAM的母亲的晚期早产和足月婴儿中的发生率，并评估新生儿感染管理的医院间差异。2010年在Kaiser Permanente Southern加州医院妊娠35周（n = 31，112）。电子医疗和实验室记录从13个医疗中心进行了检查，产妇体温，产时，新生儿抗生素治疗。估计IPF、CAM和CPEOI的发生率。结果IPF和CAM的发生率分别为9%和4%。CPEOI的总体发生率为0.61/1，000（95%置信区间[CI] 0.34，0.89/1，000）。CAM母亲所生婴儿的CPEOI率为4.0/1，000（95% CI 0.50，7.5/1，000）。婴儿开始使用抗生素的母亲与CAM之间nurses. ConclusionCPEOI的母亲与CAM所生的婴儿的比率低于以前报道的从7到76%不等。产科医生在新生儿抗生素的使用上存在异质性。
Objective The risk of infection in infants of mothers with chorioamnionitis (CAM) may be lower than previously reported. This study's objective was to determine the incidence of intrapartum fever (IPF) and culture-positive early-onset bacterial neonatal infection (CPEOI) in the late preterm and term infants of mothers with or without CAM and to assess interhospital variation in neonatal infection management.Study Design This retrospective cohort study included mothers and newborns delivered at >= 35 weeks gestation at Kaiser Permanente Southern California Hospitals in 2010 (n = 31,112). Electronic medical and laboratory records from 13 medical centers were examined for maternal temperature, intrapartum, and neonatal antibiotic treatment. Rates for IPF, CAM, and CPEOI were estimated. Rates for starting neonatal antibiotics were calculated.Results The incidence of IPF was 9% and CAM 4%. The overall rate for CPEOI was 0.61/1,000 (95% confidence interval [CI] 0.34, 0.89/1,000). The rate of CPEOI was 4.0/1,000 (95% CI 0.50, 7.5/1,000) in infants born to mothers with CAM. The rate of beginning antibiotics for infants born to mothers with CAM ranged from 7 to 76% between nurseries.Conclusion The rate of CPEOI in infants born to mothers with CAM is lower than previously reported. There is heterogeneity in initiation of neonatal antibiotics by neonatologists.