PMID- 31409304
OWN - NLM
STAT- MEDLINE
DCOM- 20201210
LR  - 20201214
IS  - 1471-2431 (Electronic)
IS  - 1471-2431 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Aug 13
TI  - Management of Late Preterm and Term Neonates exposed to maternal 
      Chorioamnionitis.
PG  - 282
LID - 10.1186/s12887-019-1650-0 [doi]
LID - 282
AB  - BACKGROUND: Chorioamnionitis is a significant risk factor for early-onset 
      neonatal sepsis. However, empiric antibiotic treatment is unnecessary for most 
      asymptomatic newborns exposed to maternal chorioamnionitis (MC). The purpose of 
      this study is to report the outcomes of asymptomatic neonates >/=35 weeks 
      gestational age (GA) exposed to MC, who were managed without routine antibiotic 
      administration and were clinically monitored while following complete blood cell 
      counts (CBCs). METHODS: A retrospective chart review was performed on neonates 
      with GA >/= 35 weeks with MC during calendar year 2013. IT ratio (immature: total 
      neutrophils) was considered suspicious if >/=0.3. The data were analyzed using 
      independent sample T-tests. RESULTS: Among the 275 neonates with MC, 36 received 
      antibiotics for possible sepsis. Twenty-one were treated with antibiotics for 
      > 48 h for clinical signs of infection; only one infant had a positive blood 
      culture. All 21 became symptomatic prior to initiating antibiotics. Six showed 
      worsening of IT ratio. Thus empiric antibiotic administration was safely avoided 
      in 87% of neonates with MC. 81.5% of the neonates had follow-up appointments 
      within a few days and at two weeks of age within the hospital system. There were 
      no readmissions for suspected sepsis. CONCLUSIONS: In our patient population, 
      using CBC indices and clinical observation to predict sepsis in neonates with MC 
      appears safe and avoids the unnecessary use of antibiotics.
FAU - Sahni, Mitali
AU  - Sahni M
AUID- ORCID: 0000-0001-8145-2073
AD  - Division of Neonatology, Drexel University College of Medicine, Philadelphia, PA, 
      USA. mitali12@gmail.com.
AD  - St. Christopher's Hospital for Children, 160 East Erie Avenue, Philadelphia, PA, 
      19134, USA. mitali12@gmail.com.
FAU - Franco-Fuenmayor, Maria E
AU  - Franco-Fuenmayor ME
AD  - Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA.
FAU - Shattuck, Karen
AU  - Shattuck K
AD  - Division of Neonatology, Department of Pediatrics, University of Texas Medical 
      Branch, Galveston, TX, USA.
LA  - eng
PT  - Journal Article
DEP - 20190813
PL  - England
TA  - BMC Pediatr
JT  - BMC pediatrics
JID - 100967804
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Asymptomatic Infections
MH  - *Chorioamnionitis
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - Male
MH  - Pregnancy
MH  - Premature Birth
MH  - Retrospective Studies
MH  - Sepsis/*drug therapy
MH  - Term Birth
PMC - PMC6693155
OTO - NOTNLM
OT  - Antibiotics
OT  - CBC
OT  - Newborn
OT  - Sepsis
COIS- The authors declare that they have no competing interests.
EDAT- 2019/08/15 06:00
MHDA- 2020/12/15 06:00
PMCR- 2019/08/13
CRDT- 2019/08/15 06:00
PHST- 2019/01/03 00:00 [received]
PHST- 2019/07/30 00:00 [accepted]
PHST- 2019/08/15 06:00 [entrez]
PHST- 2019/08/15 06:00 [pubmed]
PHST- 2020/12/15 06:00 [medline]
PHST- 2019/08/13 00:00 [pmc-release]
AID - 10.1186/s12887-019-1650-0 [pii]
AID - 1650 [pii]
AID - 10.1186/s12887-019-1650-0 [doi]
PST - epublish
SO  - BMC Pediatr. 2019 Aug 13;19(1):282. doi: 10.1186/s12887-019-1650-0.