Sensitivity of histological chorioaminionitis and premature rupture of membranes for neonatal sepsis and its risk factors

Latar Belakang: Penyebab utama kematian bayi baru lahir atau neonatal di dunia antara lain bayi lahir premature 29%, sepsis dan pneumonia 25% dan 23% merupakan bayi baru lahir dengan asfiksia dan trauma. Sepsis neonatorum merupakan salah satu penyakit infeksi yang dapat menyebabkan kematian pada bayi baru lahir, angka kejadian sepsis di Indonesia masih tinggi yaitu 8,7% sampai 30,29% dengan angka kematian 11,56% sampai 49,9%. Kejadian sepsis neonatorum di RSUD dr. H. Moch. Ansari Saleh pada tahun 2014 sebanyak 2,9%, tahun 2015 sebanyak 1,2%, dan tahun 2016 sebanyak 1,2%.Tujuan: Menganalisis faktor risiko ibu dalam meningkatkan kejadian sepsis neonatorum di RSUD Dr. H. Moch. Ansari Saleh Tahun 2017.Metode: Penelitian kuantitatif dengan rancangan case control. Populasi penelitian ini adalah semua bayi baru lahir yang tercatat di rekam medik RSUD dr. H. Moch Ansari Saleh tahun 2017 sebanyak 4516 orang. Sampel kasus diambil dengan total sampling sebanyak 55 orang sedangkan sampel kontrol diambil dengan teknik purposive sampling sebanyak 55 orang. Data dianalisis menggunakan uji chi-square.Hasil: Faktor risiko ibu yang terjadi selama kehamilan terbukti dapat meningkatkan kejadian sepsis neonatorum yaitu persalinan lama (ρ=0,032 a=0,05), ketuban pecah dini (ρ=0,015 a=0,05), dan usia kehamilan (ρ=0,022 a=0,05). Dari ketiga faktor tersebut ibu yang mengalami ketuban pecah dini merupakan faktor yang paling berisiko menyebabkan sepsis neonatorum dibandingkan dengan yang tidak mengalami ketuban pecah dini (OR = 2,571) sedangkan faktor risiko ibu yang tidak berhubungan adalah infeksi antepartum dan komplikasi kehamilan.Simpulan: Dari lima faktor risiko ibu terdapat tiga faktor yang dapat meningkatkan kejadian sepsis neonatorum yaitu faktor yang paling beresiko adalah ketuban pecah dini dan faktor lainnya adalah persalinan lama dan usia kehamilan. Kata Kunci: Ketuban pecah dini, Persalinan lama, Sepsis neonatorum, Usia kehamilan Mother Risk Factors In Increasing The Incidence Of Neonatal Sepsis At Dr. H. Moch. Ansari Saleh Hospital Of BanjarmasinABSTRACT Background: The main causes of newborn or neonatal deaths in the world include premature babies 29%, sepsis and pneumonia 25% and 23% are newborns with asphyxia and trauma. Neonatal sepsis is one of the infectious diseases that can cause death in newborns, the incidence of sepsis in Indonesia is still high at 8.7% to 30.29% with a mortality rate of 11.56% to 49.9%. The incidence of Neonatal Sepsis at Dr. H. Moch. Ansari Saleh Hospital of Banjarmasin in 2014 as much as 2.9%, in 2015 as many as 1.2%, and in 2016 as many as 1.2%.Objective: To analyzing maternal risk factors in increasing the incidence of neonatal sepsis at Dr. H. Moch. Ansari Saleh Hospital of Banjarmasin in 2017.Methods: Quantitative research with case control design. The study population was all newborns recorded in the medical record at Dr. H. Moch. Ansari Saleh Hospital of Banjarmasin in 2017 as many as 4516 people. Case samples were taken with a total sampling of 55 people while the control samples were taken with a purposive sampling technique of 55 people. Data were analyzed using the chi-square test.Results: Maternal risk factors that occur during pregnancy have been shown to increase the incidence of neonatal sepsis, prolonged labor (ρ=0,032 a=0,05), premature rupture of membranes (ρ=0,015 a=0,05), and gestational age (ρ=0,022 a=0,05). Of the three factors, mothers who experienced premature rupture of membranes were the most at risk for causing neonatal sepsis compared with those who did not experience premature rupture of membranes (OR = 2,571) while unrelated maternal risk factors were antepartum infection and pregnancy complications.Conclusion: Of the five maternal risk factors there are three factors that can increase the incidence of neonatal sepsis, which is the most risky factor is premature rupture of the membranes and other factors are prolonged labor and gestational age. Key Words: Gestational age, Neonatal sepsis, Premature rupture of membranes, Prolonged labor

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Neonatal outcome of maternal premature rupture of membranes more than 18 hours

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v9i2.35526 ◽

2020 ◽

Vol 9 (2) ◽

pp. 81-86

Author(s):

Amshu Shakya ◽

Sweta Kumari Gupta

Keyword(s):

Risk Factors ◽

Respiratory Distress Syndrome ◽

Neonatal Sepsis ◽

Distress Syndrome ◽

Maternal Risk Factors ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Maternal Risk ◽

History Of ◽

Study Population

Background: Premature Rupture of Membranes has been known to complicate pregnancy since ages. Several risk factors may be associated with occurrence of premature rupture of membranes. It is associated with varied neonatal complications, neonatal sepsis and prematurity being the most hazardous ones. Objectives: This study was conducted to evaluate the incidence of neonatal sepsis following premature rupture of membranes, risk factors and neonatal complications associated with premature rupture of membrane of more than 18 hours in the neonates admitted in a tertiary care center. Methodology: Descriptive observational study was undertaken for 18 months from August 2013 to January 2015 in the College of Medical Sciences, Chitwan, Nepal. This study included 82 neonates admitted to the Neonatal Intensive Care Unit with maternal history of premature rupture of membranes of more than 18 hours with medical conditions excluded. Results: The incidence of premature rupture of membranes in this hospital was 8.9%. Frequently associated maternal risk factors were history of prior abortion (16, 19.5%), urinary tract infection (7, 8.5%), and antecedent coitus (7, 8.5%). In the study population, 68 (83%) neonates had complications and 14 (17%) neonates had no complication. The incidence of neonatal sepsis following PROM in present study was 6.1%. Neonatal sepsis was significantly associated with chorioamnionitis (p<0.001). The most frequently occurring complication was probable neonatal sepsis (53, 64.6%), followed by prematurity (31, 37.8%) and perinatal asphyxia (15, 18.3%). There was a directly proportional relation of neonatal sepsis, chorioamnionitis, respiratory distress syndrome and mortality with duration of premature rupture of membranes. Conclusion: Commonly occurring maternal risk factors with PROM were prior abortion, UTI and antecedent coitus. In the study population, infectious morbidity was highest. Chorioamnionitis was significantly associated with culture proven neonatal sepsis. Prolonged duration of premature rupture of membranes increased the risk of neonatal sepsis, meningitis, respiratory distress syndrome and perinatal death. Prevention of these risk factors, appropriate and timely management including improved obstetric and neonatal care can provide intact survival of the neonates.

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Risk Factors of Early-Onset Neonatal Sepsis A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-661481/v1 ◽

2021 ◽

Author(s):

Qiang Wang ◽

Guoxuan Peng ◽

Lebin Gan ◽

Jianhui Sun ◽

Dalin Wen ◽

...

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Neonatal Sepsis ◽

Early Onset ◽

Neonatal Resuscitation ◽

Labor And Delivery ◽

Premature Rupture Of Membranes ◽

Male Fetus ◽

Premature Rupture ◽

Independent Risk Factors

Abstract Background: Early-onset neonatal sepsis is a great managerial challenge worldwide. Studying the risk factors of early-onset neonatal sepsis is one of the most significant ways of reducing the incidence of sepsis and the associated health burden.Methods: A literature search strategy was constructed, including PubMed, EMBASE, Web of Science, and the Cochrane Library. All publications until April 30, 2021 were retrieved; the key words were “neonatal sepsis” and “risk factors.” Moreover, the references of the retrieved articles were screened to identify related eligible studies. Data abstraction was performed in accordance with PRISMA guidelines. The Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality scale scores were used to evaluate the quality of the included studies, and the fixed-effects model was used to combine the results. Risk factors related to the occurrence of early-onset neonatal sepsis, the pooled OR, and the 95% CI upper and lower limits were obtained to represent the correlation strength between risk factors and early-onset neonatal sepsis occurrence; the pooled I2 value was used to determine the heterogeneity of the combined results.Results: We included 21 articles with 44 non-repetitive risk factors, 91985 neonates, and 6627 cases of neonatal sepsis. We identified seven independent risk factors of early-onset neonatal sepsis, including at least three per vaginal examinations during labor and delivery, chorioamnionitis, premature rupture of membranes > 18 h, male fetus, gestational age < 37 weeks, neonatal resuscitation, and central venous catheterization, with the following ORs and 95% CIs: 7.18 (3.51-14.69), 6.56 (3.19-13.49), 2.74 (1.44-5.21), 3.03 (1.94-4.73), 4.08 (2.76-6.03), 2.6 (2.03-3.34), and 3.06 (1.64-5.73), respectively.Conclusions: Our results suggest that frequent per vaginal examination during labor and delivery, chorioamnionitis, premature rupture of membranes (> 18 h), male fetus, gestational age (< 37 weeks), neonatal resuscitation, and central vascular catheterization are independent risk factors of early-onset neonatal sepsis. These findings support the use of empirical antibiotic therapy in neonates with these risk factors.

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NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.1215 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Pramod P. Singhavi

Keyword(s):

Risk Factors ◽

Neonatal Sepsis ◽

Early Onset ◽

Late Onset ◽

Signs And Symptoms ◽

Premature Rupture ◽

Maternal Risk ◽

Late Onset Sepsis ◽

Early Onset Sepsis ◽

Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

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β-Methasone increases neonatal sepsis Simpson G, Harbert G: Use of β-methasone in management of preterm gestation with premature rupture of membranes. OBSTET GYNECOL 66:168, 1985

Journal of Nurse-Midwifery ◽

10.1016/0091-2182(86)90099-6 ◽

1986 ◽

Vol 31 (2) ◽

pp. 109

Keyword(s):

Neonatal Sepsis ◽

Obstet Gynecol ◽

Premature Rupture Of Membranes ◽

Premature Rupture

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Risk factors for prematurity and premature rupture of membranes: A prospective study of the vaginal flora in pregnancy

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(84)90392-2 ◽

1984 ◽

Vol 150 (8) ◽

pp. 965-972 ◽

Cited By ~ 310

Author(s):

Howard Minkoff ◽

Amos N. Grunebaum ◽

Richard H. Schwarz ◽

Joseph Feldman ◽

Marinella Cummings ◽

...

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Vaginal Flora ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

A Prospective Study ◽

In Pregnancy

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Extreme Preterm Premature Rupture of Membranes: Risk Factors and Feto Maternal Outcomes

Oman Medical Journal ◽

10.5001/omj.2013.28 ◽

2013 ◽

Vol 28 (2) ◽

pp. 108-111 ◽

Cited By ~ 10

Author(s):

Nihal Al Riyami ◽

Intisar Al-Ruheili ◽

Fatma Al-Shezawi ◽

Murtadha Al-Khabori

Keyword(s):

Risk Factors ◽

Maternal Outcomes ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture

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Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

10.21203/rs.3.rs-35635/v3 ◽

2020 ◽

Author(s):

Eishin Nakamura ◽

Shigetaka Matsunaga ◽

Yoshihisa Ono ◽

Yasushi Takai ◽

Hiroyuki Seki

Keyword(s):

Risk Factors ◽

Preterm Delivery ◽

Bronchopulmonary Dysplasia ◽

Roc Curve ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Extremely Preterm ◽

Gestational Week ◽

The Mean

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

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Risk factors for surgical site infections after caesarean section at Yaounde, Cameroon

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20214309 ◽

2021 ◽

Vol 10 (11) ◽

pp. 4048

Author(s):

Pierre M. Tebeu ◽

Aurelien Kamdem ◽

Jean P. Ngou-Mve-Ngou ◽

Esther Meka ◽

Jesse S. S. Antaon ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Surgical Site Infections ◽

Biomedical Sciences ◽

Midline Incision ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Cross Sectional ◽

Factors Associated ◽

Chi Squared

Background: Surgical site infection is the invasion by microorganisms of the tissue layers affected by the surgical procedure. Maternal morbidity from infections has been shown to be higher after caesarean section compared to the vaginal delivery. Objective of the research was to analyze the risk factors associated with surgical site infections after caesarean section.Methods: This was a cross sectional (affected/non affected) study approved by the institutional committee for ethics and research of the faculty of medicine and biomedical sciences. A total of 310 medical files were assessed, 62 files from patients with surgical site infections and 248 files from patients without any complications. The data was collected using a pretested questionnaire and analyzed using the statistical package for the social sciences (SPSS) software version 22.0. The Chi squared and the Fisher exact tests were used to assess homogeneity between the 2 groups. Odd ratio 95% confidence interval was used to assess the association between the variables.Results: The proportion of surgical site infections during the study was 1.81%. Factors associated with surgical site infections were premature rupture of membranes (OR: 2.065; 95% CI 1.051-4.05; p=0.035); the vertical midline incision (OR=5.26; 95% CI; 1.41-19.57; p=0.013) and a operation by a resident physician doctor (OR=1.98; 95% CI 1.09-3.59; p=0.02).Conclusions: A factors associated with surgical site infections after caesarean section are a premature rupture of membranes, vertical midline incision and the qualification of the practitioner.

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Different Management Strategies for Term Newborns Delivered with Premature rupture of membranes

10.53350/pjmhs211561423 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1423-1425

Author(s):

J. Zain ◽

M. Asim ◽

K. Firdos ◽

T. Laique

Keyword(s):

Treatment Group ◽

Neonatal Sepsis ◽

Controlled Trial ◽

Full Term ◽

Ethical Review ◽

Large Sample Size ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Insignificant Difference ◽

Term Newborns

Background: Premature rupture of membranes (PROM) is a leading cause of neonatal morbidity and mortality. Aim: To compare the outcomes of prophylactic versus selective antibiotics in term newborns born after PROM > 18 hours in terms of neonatal sepsis and resistance of neonatal. Study design: Randomized controlled trial. Methodology: This study enrolled (n=120) asymptomatic term (37+ weeks) babies of either gender with PROM > 18 hours after ethical review committee’s (ERC) approval. This study held at DHQ Hospital, Rawalpindi-Pakistan in 2019. Data was collected through a structured proforma with informed consent. Data was analyzed by SPSS, v-20. The study outcomes were neonatal sepsis and resistant neonatal flora. Chi-square test was applied with p≤0.05 taken as significant. Results: The neonatal sepsis was diagnosed in 8 (13.3%) and 9(15%) babies in the prophylactic treatment group and the selective treatment group, respectively having statistically insignificant difference (p>0.05). Likewise, resistant neonatal flora between both groups showed statistically insignificant difference (p>0.05). Conclusion: We concluded that there was insignificant difference in terms of rates of neonatal sepsis and resistant neonatal flora between two treatment groups. However, there is a need to conduct large sample size, multicentre studies to validate these results before making recommendations for routine treatment of full term babies with PROM >18 hours in our clinical settings. Keywords: Neonates, Premature Rupture Of Membranes, Full Term, Neonatal Sepsis and Resistant Neonatal Flora.

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