title: Risk factors for neonatal sepsis.
abstract: 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. Culture-proven 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Tripler Army Medical Center, Hawaii, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Yancey
authors.forename: P
authors.initials: P
authors.lastname: Duff
authors.forename: P
authors.initials: P
authors.lastname: Kubilis
authors.forename: P
authors.initials: P
authors.lastname: Clark
authors.forename: B H
authors.initials: BH
authors.lastname: Frentzen
mesh_terms: D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000628:therapy