Association of delivery risk phenotype with early-onset sepsis in preterm infants

J Perinatol. 2023 Sep;43(9):1166-1172. doi: 10.1038/s41372-023-01743-z. Epub 2023 Aug 5.

Abstract

Objective: To determine delivery risk phenotype-specific incidence of early-onset sepsis (EOS) among preterm infants.

Study design: Retrospective cohort study of infants born <35 weeks' gestation at four perinatal centers during 2017-2021. Infants were classified into one of six delivery risk phenotypes incorporating delivery mode, presence of labor, and duration of rupture of membranes (ROM). The primary outcome was EOS incidence within the overall cohort and each risk phenotype.

Results: Among 2937 preterm infants, 21 had EOS (0.7%, or 7.1 cases/1000 preterm infants). The majority of EOS cases (13/21, 62%) occurred in the setting of prolonged ROM ≥ 18 h, with a phenotype incidence of 23.8 cases/1000 preterm infants. There were no EOS cases among infants born by cesarean section without ROM (with or without labor), nor via cesarean section with ROM < 18 h without labor.

Conclusion: Delivery risk phenotyping may inform EOS risk stratification in preterm infants.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Cesarean Section
  • Female
  • Fetal Membranes, Premature Rupture* / epidemiology
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Pregnancy
  • Retrospective Studies
  • Sepsis* / epidemiology