The role of intrapartum fever in identifying asymptomatic term neonates with early-onset neonatal sepsis.
OBJECTIVE
To assess the role of intrapartum fever in identifying asymptomatic term neonates with early-onset neonatal sepsis.


METHODS
Retrospective review of all term neonates with sepsis over a 7-year period to evaluate the significance of symptoms at delivery and intrapartum sepsis risks factors in identifying neonates with sepsis.


RESULTS
Fifty-three of 90 term neonates with sepsis (59%) were asymptomatic at delivery. Thirty-five of 53 asymptomatic term neonates (66%) met criteria for sepsis evaluations and 18 (34%) were evaluated when symptoms developed after delivery. Among the 35 asymptomatic term neonates meeting criteria for sepsis evaluations, 14 (40%) had evaluations because of intrapartum fever. Thus, 14 of 53 (26%) asymptomatic term neonates with sepsis (30% of GBS sepsis and 11% of non-GBS sepsis) would not have been evaluated if intrapartum fever were ignored.


CONCLUSIONS
Over half of term neonates with sepsis were asymptomatic at delivery. Intrapartum fever was helpful in identifying over a quarter of asymptomatic term neonates with sepsis.
Chen
Katherine T
KT
Department of Obstetrics, Gynecology, and Reproductive Biology, Division of Maternal-Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Ringer
Steven
S
Cohen
Amy P
AP
Lieberman
Ellice
E
D036861:Delivery, Obstetric; D005260:Female; D005334:Fever / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D013290:Streptococcal Infections / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D013997:Time Factors