Puopolo et al identified antepartum maternal risk factors associated with early onset sepsis (EOS) in the neonate. These can help to identify a neonate who may benefit from more aggressive management. The authors are from Brigham and Women's Hospital, Harvard Medical School, Children's Hospital Boston, University of California Santa Cruz, University of Califonria San Francisco, Kaiser Permanente, and Beth Israel-Deaconess Medical Center Boston.


Patient selection: gestational age >= 34 weeks


Early onset neonatal sepsis (EOS): bacterial sepsis with onset < 72 hours after birth


Risk factors for early onset infection (from multivariate analysis):

(1) highest maternal intrapartum temperature >= 100.5°F (especially when >= 101.5°F)

(2) duration of membrane rupture >= 12 hours

(3) failure to give any intra-partum antibiotic


Additional risk factors (from bivariate analysis, Table 3):

(1) gestational age < 37 weeks or >= 41 weeks (non-term)

(2) epidural anesthesia

(3) administration of antibiotic < 4 hours prior to delivery (not apparent in Table 5)


Presumably there would be risk if the mother was positive for Group B Streptococcus and did not receive prophylactic antibiotics.


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