Management of term newborns following maternal intrapartum fever

Management of term newborns following maternal intrapartum fever
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产妇产时发热后足月新生儿的处理

DOI：
10.3109/14767058.2012.722727
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发表时间：
2013
期刊：
The Journal of Maternal-Fetal & Neonatal Medicine
影响因子：
--
通讯作者：
N. Melamed
N. Melamed
中科院分区：
--
文献类型：
--
作者：
N. Linder;Elena Fridman;Ayman Makhoul;D. Lubin;G. Klinger;Tami Laron;Y. Yogev;N. Melamed

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目的：探讨产时发热母亲所生足月新生儿的诊断和治疗方法。研究方法：在一项回顾性研究中，将产时发热（≥37.8°C）母亲所生的新生儿与胎龄和出生体重匹配的对照组进行比较。结果：总的来说，159名单胎足月新生儿出生的妇女产时发热（研究组）进行了比较，159名对照婴儿。两组新生儿结局无差异，除了母亲发热组羊水粪染率较高。两组均无新生儿感染、严重新生儿发病或新生儿死亡病例。研究组中17.6%的新生儿接受了全面的败血症检查和静脉抗生素治疗。Logistic回归分析显示，剖宫产分娩是唯一与产妇产时发热患者决定进行全面脓毒症检查和抗生素治疗独立相关的因素（OR 32.0，95%CI 9.4-112.1）。结论：在无症状产时发热的低风险妇女中，新生儿感染并不常见，因此可能没有必要对这些婴儿进行积极的评估和管理，并应与新生儿败血症的低风险相平衡。
Objective: To evaluate the diagnostic and therapeutic approach to full term neonates born to mothers with intrapartum fever. Methods: In a retrospective study, neonates born to mothers with intrapartum fever, (≥37.8°C), were compared to control group matched by gestational age and birthweight. Results: Overall, 159 singleton full term neonates born to women with intrapartum fever (study group) were compared to 159 control infants. No differences in neonatal outcomes were found between the two groups except for a higher rate of meconium-stained amniotic fluid in the maternal-fever group. There were no cases of neonatal infection, severe neonatal morbidity, or neonatal mortality in either of the groups. Full sepsis workup and intravenous antibiotic treatment were provided to 17.6% of the neonates in the study group. Logistic regression analysis revealed that delivery by Cesarean section was the only factor independently associated with the decision to perform a full sepsis work up and antibiotic treatment in cases of maternal intrapartum fever (OR 32.0, 95% CI 9.4–112.1). Conclusions: In low-risk women with asymptomatic intrapartum fever, neonatal infection is uncommon, so that aggressive evaluation and management of these infants may not be necessary and should be balanced against the low risk of neonatal sepsis.
Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. A randomized controlled trial. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.
抗生素治疗可降低早产胎膜早破后婴儿的发病率。
DOI： --
发表时间： 1997
期刊： JAMA : the journal of the American Medical Association
影响因子： --
作者：
Mercer,BM;Miodovnik,M;Thurnau,GR;Goldenberg,RL;Das,AF;Ramsey,RD;Rabello,YA;Meis,PJ;Moawad,AH;Iams,JD;VanDorsten,JP;Paul,RH;Bottoms,SF;Merenstein,G;Thom,EA;Roberts,JM;McNellis,D
通讯作者： McNellis,D