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Delivery Characteristics Predict Early-Onset Sepsis Risk

Criteria for low risk include C-section, membrane rupture, absence of clinical chorioamnionitis

THURSDAY, Oct. 5, 2017 (HealthDay News) — Delivery characteristics of extremely preterm infants can be used to identify those with significantly lower incidence of early-onset sepsis (EOS), according to a study published online Oct. 5 in Pediatrics.

Karen M. Puopolo, M.D., Ph.D., from Children’s Hospital of Philadelphia , and colleagues analyzed data from infants born at 22 to 28 weeks’ gestation in Neonatal Research Network centers from 2006 to 2014 to determine whether factors evident at birth could be used to identify premature infants at lower risk of EOS (≤72 hours’ age).

The researchers found that of 15,433 infants, 37 percent met low-risk criteria (delivered via cesarean delivery, with membrane rupture at delivery, and absence of clinical chorioamnionitis). Among infants surviving >12 hours, EOS incidence was 29 out of 5,640 (0.5 percent) in the low-risk group versus 209 out of 8,422 (2.5 percent) in the comparison group (adjusted relative risk, 0.24). Prolonged antibiotics (five or more days) were administered to 34 percent of low-risk infants versus 47 percent of comparison infants without EOS.

“Recognition of differential risk may help guide decisions to limit early antibiotic use among approximately one-third of these infants,” conclude the authors.

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