title: Septicaemia of the newborn, associated with ruptured foetal membranes, discoloured amniotic fluid or maternal fever.
abstract: The incidence of neonatal septicaemia associated with prolonged rupture of foetal membranes, discoloured amniotic fluid and/or maternal fever was investigated. A total of 807 blood cultures were performed on 329 neonates, the placental end of 239 umbilical cords and on 239 mothers. The study showed that in 97% of the neonates with a complicated delivery there was no evidence of septicaemia. Septicaemia was verified in 3% of the infants, and was intimately associated with low birth weight (p equals 0.02), neonatal asphyxia (p less than 10(-4)), clinical evidence of septicaemia (p less than 10(-4) and maternal fever (p equals 0.002). The incidence was particularly high in premature infants with neonatal asphyxia (27%) and in neonates born to febrile mothers (20%). None of the mothers showed any evidence of septicaemia, and haematogenous, transplacental spread of infection to the child was not seen. Routine prophylactic antibiotic therapy in neonates with a complicated delivery should therefore be reserved, in our opinion, for those infants at high risk of infection.
mesh_terms: D000653:Amniotic Fluid; D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000150:complications; D001431:Bacteriological Techniques; D001769:Blood / Q000382:microbiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications*; D005334:Fever / Q000150:complications; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology*; D008297:Male; D008431:Maternal-Fetal Exchange; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011248:Pregnancy Complications; D018805:Sepsis / Q000209:etiology*; D012737:Sex Factors; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification