Clinical Study On Antibiotic Therapy In 221 Cases Of Hospitalized Newborns With Intrapartum Maternal Fever

Objective: To analyze the use of antibiotics in neonates with intrapartum maternal fever during hospitalization and to understand the influencing factors of antibiotic course.Method: Data of 221 full-term infants admitted to the First Affiliated Hospital of Xinjiang Medical University due to intrapartum maternal fever from January 2020 to December2022 were collected,and 221 cases of full-term infants who were treated with antibiotics were included.They were divided into a short course group(≤ 3 days)and a medium to long course group(>3 days)based on the duration of use.Clinical data,antibiotic use,and relevant blood test indicators were compared between the two groups.Result: In this study,there were 53 cases in the short course group(23.9%)and 168 cases in the medium to long course group(76.1%).The first-time blood test of inflammatory indicators of newborns in the medium to long course group were higher than those in the short course group(CRP 14.15mg/L(9.20,20.75)vs 7.90mg/L(5.95,14.05),PCT 2.48ng/ml(1.22,4.85)vs 1.51ng/ml(0.70,2.84)),and the differences were statistically significant(P<0.05);The second blood test of inflammatory indicators of newborns in the medium to long course group was higher than that in the short course group(CRP 15.2mg/L(11.20,22.65)vs8.2mg/L(6.60,10.60),PCT 1.6ng/ml(0.75,3.40)vs 0.99ng/ml(0.49,1.76),and the differences were statistically significant(P<0.05).There was no statistically significant difference in WBC count and CRP between the two groups before pregnancy,as well as in WBC count during the first and second blood tests of newborns after birth;The proportion of amniotic fluid contamination,confirmed chorioamnionitis,and premature rupture of membranes in the medium to long course group was higher than that in the short course group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the independent risk factors for prolonged antibiotic treatment were: The increase of the second blood test of CRP(OR=1.178,95% CI 1.086-1.279,P<0.05),occurrence of premature rupture of membranes(OR=2.384,95% CI1.039-5.470,P<0.05),and confirmed chorioamnionitis(OR=3.344,95% CI 1.503-7.438,P<0.05).Conclusion: Neonates with intrapartum maternal fever during hospitalization have a higher rate of antibiotic use and a longer course of treatment;The increase of the second blood test of CRP after birth,the occurrence of premature rupture of membranes,and the diagnosis of chorioamnionitis are independent risk factors for long antibiotic treatment courses.The first and second blood test of WBC count after birth,as well as the prenatal WBC count and CRP levels of pregnant women,have no significant clinical guidance significance for the duration of antibiotic treatment.