Risk factors for neonatal sepsis.
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.
Yancey
M K
MK
Department of Obstetrics and Gynecology, Tripler Army Medical Center, Hawaii, USA.
Duff
P
P
Kubilis
P
P
Clark
P
P
Frentzen
B H
BH
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