Research In Practice Blog

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Can delivery circumstances inform early-onset sepsis risk in preterm infants?
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By Sarah Coggins, MD, MSCE

Intro
Infants born prematurely have a greater likelihood of experiencing complications and health issues. One such issue is early-onset sepsis (EOS)—a serious and potentially fatal infection of the blood and/or cerebrospinal fluid occurring within the first three days after birth. Delivery characteristics – including mode of delivery, presence of labor, and rupture of membranes (ROM) duration prior to delivery – are all thought to contribute to EOS risk. However, a framework was lacking to understand the association of these combinations of delivery characteristics with EOS incidence in preterm infants. 

Study design & findings
Deliveries of 2,937 pre-term infants were categorized by delivery mode, presence of labor, and duration of ROM. Then, the researchers analyzed EOS occurrence across groups to further understand which subsets of pre-term infants had the highest EOS incidence. A total of 21 (0.7%) of infants studied had EOS, and the majority were born in the setting of prolonged ROM (≥18 hours).

Implications 
These data suggest that certain delivery circumstances are associated with higher rates of EOS in pre-term infants.  Validation of these findings in a larger cohort may help better direct resources, inform deployment of preventive measures, and help reduce unnecessary antibiotic exposure for those at a lower risk for infection.

Clinical Futures author(s):
Sarah Coggins, MD, MSCE; Sagori Mukhopadhyay, MD, MMSc; Kevin Downes, MD; Karen M. Puopolo, MD, PhD

Publication: Association of delivery risk phenotype with early-onset sepsis in preterm infants
Citation: Coggins SA, Mukhopadhyay S, Triebwasser J, Downes KJ, Christie JD, Puopolo KM. Association of delivery risk phenotype with early-onset sepsis in preterm infants. J Perinatol. 2023;43(9):1166-1172. doi:10.1038/s41372-023-01743-z

Related Information & Research
•    CHOP information about Premature Rupture of Membranes & Preterm Premature Rupture of Membranes
•    CHOP Pediatric Sepsis Program
•    More Clinical Futures authors’ publications on Sepsis

Research Methodological Pillar: Clinical Epidemiology