Abstract | OBJECTIVE: The purpose of this study was to determine the incidence, causative pathogens, and risk factors for early onset sepsis (EOS) among very-low- birthweight (VLBW) infants. STUDY DESIGN: This was a population based observational study. Data were prospectively collected by the Israel Neonatal Network between 1995 and 2005. Multivariable analyses identified independent risk factors for EOS. RESULTS: EOS developed in 383 of 15,839 infants (2.42%). Fifty-five percent of pathogens isolated were gram-negative bacteria. Lack of prenatal care (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.32-2.86), delivery room resuscitation (OR, 2.49; 95% CI, 1.91-3.24), membrane rupture > 24 hours without amnionitis (OR, 2.10; 95% CI, 1.53-2.88), amnionitis with membrane rupture < 24 hours (OR, 4.28; 95% CI, 2.97-6.16), and amnionitis with membrane rupture >or= 24 hours (OR, 8.15; 95% CI, 5.98-11.10) were associated with EOS, but not antenatal steroids or gestational age. CONCLUSION: EOS was caused mainly by gram-negative bacteria. Prolonged rupture of membranes and amnionitis have an additive effect on EOS with an above 8-fold excess risk when both were present.
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Authors | Gil Klinger, Itzhak Levy, Lea Sirota, Valentina Boyko, Brian Reichman, Liat Lerner-Geva, Israel Neonatal Network |
Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 201
Issue 1
Pg. 38.e1-6
(Jul 2009)
ISSN: 1097-6868 [Electronic] United States |
PMID | 19380122
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Age of Onset
- Bacteremia
(epidemiology)
- Chorioamnionitis
(epidemiology)
- Female
- Fetal Membranes, Premature Rupture
(epidemiology)
- Humans
- Incidence
- Infant, Newborn
- Infant, Premature, Diseases
(epidemiology)
- Infant, Very Low Birth Weight
- Israel
(epidemiology)
- Multivariate Analysis
- Pregnancy
- Risk Factors
- Sepsis
(epidemiology)
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