Chorioamnionitis and the prognosis for term infants

Alexander, J.; McIntire, Donald; Leveno, Kenneth J.

doi:10.1016/s0029-7844(99)00256-2

Cited by 116 publications

(90 citation statements)

References 10 publications

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“…1,2 The incidence of earlyonset neonatal sepsis is significantly increased in neonates exposed to CAM. 3,4 The risk of early-onset neonatal sepsis is reduced with administration of antibiotics during labor and delivery to mothers who have CAM. 5,6 However, the use of intrapartum antibiotics reduces the sensitivity of postnatal blood cultures in neonates.…”

Section: Discussionmentioning

confidence: 99%

Role of Guidelines on Length of Therapy in Chorioamnionitis and Neonatal Sepsis

et al. 2014

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BACKGROUND AND OBJECTIVE: Chorioamnionitis (CAM) is a major risk factor for neonatal sepsis. At our institution, neonates exposed to CAM and intrapartum antibiotics are treated with prolonged antimicrobial therapy if laboratory values are abnormal despite a sterile blood culture. Recently, the Committee on the Fetus and Newborn (COFN) recommended a similar strategy for treating neonates exposed to CAM. Our objective was to determine the frequency of abnormal laboratory parameters in term and late-preterm neonates exposed to CAM and evaluate the implication of recent COFN guidelines. METHODS: This retrospective data analysis included late-preterm and term neonates exposed to CAM. Laboratory parameters, clinical symptoms and the number of infants treated with prolonged antibiotics were determined. RESULTS: A total of 554 infants met the inclusion criteria. Eighty-three infants (14.9%) had an abnormal immature to total neutrophil ratio (>0.2) and 121 infants (22%) had an abnormal C-reactive protein level (>1 mg/dL) at 12 hours of age. A total of 153 infants (27.6%) had an abnormal immature to total neutrophil ratio and/or abnormal C-reactive protein level at 12 hours of age. Only 4 (0.7%) of 554 infants had a positive blood culture result. A total of 134 (24.2%) infants were treated with prolonged antibiotics (112 [20.2%] were treated solely based on abnormal laboratory data). Lumbar puncture was performed in 120 (21.6%) infants. CONCLUSIONS: When managed by using a strategy similar to recent COFN guidelines, a large number of term and late-preterm infants exposed to CAM who had sterile blood culture findings were treated with prolonged antibiotic therapy due to abnormal laboratory findings. They were also subjected to additional invasive procedures and had a longer duration of hospitalization.

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Section: Discussionmentioning

confidence: 99%

Role of Guidelines on Length of Therapy in Chorioamnionitis and Neonatal Sepsis

et al. 2014

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“…115,116 For the important outcome of neonatal seizures, we identified lowquality evidence from 7 nonrandomized clinical trials (downgraded for risk of bias) showing an increased risk with maternal hyperthermia. [115][116][117][118][119][120][121] For the important outcome of adverse neurologic states (encephalopathy), we identified low-quality evidence from 4 nonrandomized clinical trials (downgraded for risk of bias) showing an increased risk with maternal hyperthermia.…”

Section: Consensus On Science Maternal Hyperthermiamentioning

confidence: 99%

Part 7: Neonatal Resuscitation

Perlman¹,

Wyllie²,

Kattwinkel³

et al. 2015

Pediatrics

234

291

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“…8 Looff and Hager describe amnionitis as a significant cause of maternal fever in obstetrics. 9 Our data concurs with this fact in that all patients in Groups I and II with amnionitis also had fever during labour compared to only 1% in Group III.…”

Section: Discussionmentioning

confidence: 99%

Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour

Vallejo

Kaul

Adler

et al. 2001

Can J Anesth/J Can Anesth

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Purpose: Maternal fever is associated with chorioamnionitis and has been linked to labour epidural analgesia (LEA). The purpose of this study was to determine possible associations between LEA and chorioamnionitis, maternal fever, operative delivery rate, and neonatal outcome.Methods: Data from 14,073 patients were entered into a database over a two-year period. From this database, 62 nulliparous parturients with clinical chorioamnionitis (amnionitis), but without LEA were identified (Group I). Two other groups who received LEA were matched for parity and gestation: Group II -LEA with concomitant amnionitis (n=50) and, Group III -LEA without concomitant amnionitis (n=201). The diagnosis of chorioamnionitis was confirmed by histologic examination. Results are expressed as mean ± SD and analyzed at P <0.05 using ANOVA or Chi-square.

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Chorioamnionitis and the prognosis for term infants

Abstract: The main short-term neonatal consequence of chorioamnionitis is infection. Short-term neurologic morbidity in infants is related to labor complications and not chorioamnionitis per se.

Cited by 116 publications

References 10 publications

Role of Guidelines on Length of Therapy in Chorioamnionitis and Neonatal Sepsis

Role of Guidelines on Length of Therapy in Chorioamnionitis and Neonatal Sepsis

Part 7: Neonatal Resuscitation

Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour

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