Analysis Of Risk Factors For Early-onset Sepsis In Term Infants Exposed To Intrauterine Infection

Objectives:By analyzing the high risk factors of early-onset sepsis(EOS)in term infants with intrauterine infection,it helps to early identify high-risk EOS term infants and provides a reference for the use of antibiotics.Method:A total of 245 full-term neonates in our hospital born to the women with intrauterine infection between January 1,2020 and December 31,2022 were recruited.The study population were divided into EOS group and non-EOS group according whether were diagnosed as EOS,including clinical EOS group and confirmed EOS group.The clinical data of subjects were retrospectively analyzed,including the general condition of pregnant women and newborns,prenatal laboratory tests,maternal illness,perinatal characteristics,clinical manifestation and postnatal laboratory examination of the newborns.First univariate analysis was performed on two sets of data,and then the multivariate logistics regression model was used to evaluate the risk factors of EOS in full-term infants delivered by women with intrauterine infection.Finally,the ROC curve plotted to analyse the predictive value of risk factors.Results:1.Maternal prenatal temperature,prenatal group B streptococcal(GBS),positive rate of genital tract secretion culture,and the incidences of premature rupture of membranes,neonatal fever and and amniotic fluid contamination in the EOS group were higher than those in the non-EOS group(P<0.05).There were no significant differences in the levels of white blood cells,neutrophils and C-creative protein between the two group(P>0.05).The prenatal body temperature,prenatal GBS infection rate,positive rate of genital tract secretion culture,and amniotic fluid contamination rate in clinical EOS group were higher than those in non-EOS group(P<0.05).2.The logistic regression analysis indicated that antenatal fever,prenatal GBS infection,genital tract secretion culture positive,meconium-stained amniotic fluid and neonatal fever were independent predictors of the risk of EOS in term infants delivered by pregnant women with intrauterine infection(P < 0.05).When the antepartum fever peak of 38.3℃,the Youden index was the largest that showed the highest probability of predicting EOS(sensitivity 73.9%).3.These were significant risk factors for clinical EOS,including prenatal fever,amniotic fluid muddy and positive genital tract culture(P<0.05).At a prenatal thermal peak of 38.2℃,largest Youden index had the high probability of clinical EOS(sensitivity 70.3%).Conclusions:1.The was no association between the levels of white blood cells,neutrophil count and C-reactive protein and the incidence of EOS in newborns born to women with intrauterine infection.There is insufficient evidence to guide antibiotic therapy in neonates by maternal inflammatory indicators.2.Prenatal fever,GBS infection,positive genital tract culture,amniotic fluid muddy and neonatal fever were independent risk factors for EOS.If multiple risk factors can predict EOS with high accuracy,it is suggested to observe the newborns closely,complete laboratory examinations and prophylactic antibiotic.