Elsevier

Obstetrics & Gynecology

Volume 87, Issue 2, February 1996, Pages 188-194
Obstetrics & Gynecology

Risk factors for neonatal sepsis*

https://doi.org/10.1016/0029-7844(95)00402-5Get rights and content

Objective

To determine the associations between maternal characteristics, intrapartum events, and neonatal sepsis by multivariate analysis.

Methods

We enrolled 823 women from a high-risk population and analyzed maternal and neonatal demographic and outcome variables with univariate analysis and multivariate logistic modeling.

Results

Two-hundred sixteen women (26%) were colonized with group B streptococci, 82 (10%) developed chorioamnionitis, and 141 (17%) delivered prematurely. Cultureproven neonatal sepsis or meningitis was found in 15 of 833 (1.8%) neonates, and 101 of the remaining 818 (12.3%) infants were suspected to have sepsis or pneumonia. Multivariate analysis of risk factors for proven neonatal sepsis demonstrated a statistically significant association with decreasing gestational age, duration of internal monitoring for more than 12 hours (odds ratio [OR] 7.2, 95% confidence interval [CI] 1.6–32.2), maternal group B streptococcal infection (OR 4.2, 95% CI 1.4–13.1), chorioamnionitis (OR 4.4, 95% CI 1.2–16.1), and endometritis (OR 6.4, 95% CI 1.2–34.2).

Conclusion

Through the use of multivariate modeling, we determined that chorioamnionitis or endometritis, preterm delivery, group B streptococcal colonization, and a prolonged duration of internal monitoring are independent risk factors for neonatal sepsis. We postulate that the presence of a foreign body that traverses the birth canal may facilitate ascending peripartal infection.

References (25)

  • BoyerKM et al.

    Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. 1. Epidemiologic rationale

    J Infect Dis

    (1983)
  • SchuchatA et al.

    Population-based risk factors for neonatal group B streptococcal disease: Results of a cohort study in metropolitan Atlanta

    J Infect Dis

    (1990)
  • Cited by (0)

    *

    The assertions and opinions contained herein are the expressed views of the authors and are not to be construed as official or as reflecting the opinions of the Department of Defense or the Department of the Army.

    View full text