Effect of Intrapartum Antibiotic Exposure Time on Neonatal Sepsis: A Prospective Cohort Study.

IF 1.5 4区医学 Q2 PEDIATRICS

Indian pediatrics Pub Date : 2025-08-06 DOI:10.1007/s13312-025-00133-2

Rishi Sharma, Sourabh Dutta, Vanita Suri, Pallab Ray, Mandula Phani Priya

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引用次数: 0

Abstract

Objective: To examine the association between the duration of intrapartum antibiotic exposure (IAE) and the risk of culture-negative early-onset neonatal sepsis (EONS) and any late-onset neonatal sepsis (LONS) in the first week.

Methods: Preterm neonates (≤ 34 weeks) were enrolled into: Group A (no IAE; n = 282), Group B (IAE < 24 h; n = 204) and Group C (IAE ≥ 24 h; n = 84). The risk factors for EONS and LONS were noted and all neonates were followed up for culture-negative EONS (primary outcome). Secondary outcomes included culture-positive EONS, culture-negative and culture-positive LONS, and multidrug-resistant sepsis. A univariable followed by multivariable analysis of risk factors to predict culture-negative EONS and LONS was performed. The cut-off (Youden's index) of IAE associated with various outcomes was determined.

Results: From group A through C, gestation and birth weight declined, and the proportion at risk of EONS increased. Culture-negative EONS incidence increased (9.57% vs. 12.74% vs. 36.90%, respectively, P_trends < 0.001), but its proportion among all EONS did not. Culture-positive LONS incidence declined (P_trends = 0.038). The proportion of culture-negative LONS among all LONS increased (P_trends = 0.024). Threshold values of 13.5 h and 4.5 h were associated with culture-negative EONS and culture-positive LONS in the first week, respectively. However, on adjusted analysis, IAE duration had no association with culture-negative EONS or LONS in the first week.

Conclusions: Duration of IAE is not independently associated with increased incidence of culture-negative EONS or any LONS.

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产时抗生素暴露时间对新生儿败血症的影响：一项前瞻性队列研究。

目的：探讨产时抗生素暴露时间（IAE）与第一周培养阴性早发型新生儿脓毒症（EONS）和任何晚发型新生儿脓毒症（LONS）风险的关系。方法：早产儿（≤34周）分为：A组(无IAE；结果：从A组到C组，妊娠期和出生体重下降，发生EONS的危险比例增加。培养阴性EONS发生率分别为9.57%、12.74%、36.90%，p趋势趋势= 0.038。培养阴性的LONS占所有LONS的比例增加（p趋势= 0.024）。第一周的阈值分别为13.5 h和4.5 h与培养阴性的EONS和培养阳性的LONS相关。然而，经调整分析，IAE持续时间与第一周培养阴性EONS或LONS无关。结论：IAE的持续时间与培养阴性EONS或任何LONS的发生率增加无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.