Investigation Of The Correlations Between Maternal Infectious Risk Factors And Early-Onset Bacterial Infection In Newborns<34 Weeks’ Gestation

Objective:To explore correlations between maternal infectious risk factors, histopathological alterations of the placental infection/inflammation and early-onset bacterial infection(EOBI) in newborns<34 weeks’ gestation, so as to find an access to early prevention, early diagnosis and rational use of antibiotics.Method:This was a retrospective case-control study of 253 live births< 34 weeks’ gestation, treated in NICU after birth immediately, at the 1st Affiliated Hospital of Kunming Medical University, from January 2014 to December 2015. This study collected clinical data of maternal infectious risk factors, conditions of newborns at delivery, diseases during neonatal period and pathological diagnoses of detected placentas. Case-subjects were diagnosed with EOBI, controls were not. Gender, gestational age(GA), birth weight(BW), birth way, premature rupture of membrane(PROM)≥18 hours, positive culture of cervical secretion, maternal fever (T ≥37.8℃), clinical chorioamnionitis(cCA), histopathological acute chorioamnionitis (hACA), asphyxia diagnosed by Apgar scores, umbilical artery blood PH, antepartum antibiotic therapy were conducted stastic analysis, as well as the histopathological alterations of the placental infection/inflammation(PI). The factors were analyzed by SPSS17.0, P=0.05.Results:78 (30.83%) EOBI,9 (3.56%) confirmed early-onset sepsis (EOS) were identified during the 253 cases, and the fatality is 11.54%. GA (P=0.000)、cCA (P=0.033) and maternal fever(P=0.000) were related to EOBI in newborns< 34 weeks’gestation. By logistic regression analysis, maternal fever(OR 3.264,95%CI 1.404-7.584) was the only independent risk factor, GA(OR 0.754,95%CI 0,634-0.896) was the independent protective factor. Any of the histopathological alterations of the placental infection/inflammation was not correlated.Conclusion:1.CA、maternal fever are the risk factor for EOBI in newborns<34 weeks’ gestation, and maternal fever is the independent one.2.GA is the protective factor for EOBI in newborns<34 weeks’ gestation.3. HACA is not so helpful for predicting EOBI in newborns<34 weeks’ gestation.4.Antepartum or intrapartum antibiotic therapy can not prevent EOBI in newborns< 34 weeks’ gestation.