RISK-FACTORS FOR NEONATAL SEPSIS

Objective: To determine the associations between maternal characterist ics, intrapartum events, and neonatal sepsis by multivariate analysis. Methods: We enrolled 823 women from a high-risk population and analyz ed maternal and neonatal demographic and outcome variables with univar iate analysis and multivariate logistic modeling. Results: Two-hundred sixteen women (26%) were colonized with group B streptococci, 82 (10% ) developed chorioamnionitis, and 141 (17%) delivered prematurely. Cul ture-proven neonatal sepsis or meningitis was found in 15 of 833 (1.8% ) neonates, and 101 of the remaining 818 (12.3%) infants were suspecte d to have sepsis or pneumonia. Multivariate analysis of risk factors f or proven neonatal sepsis demonstrated a statistically significant ass ociation with decreasing gestational age, duration of internal monitor ing for more than 12 hours (odds ratio [OR] 7.2, 95% confidence interv al [CI] 1.6-32.2), maternal group B streptococcal infection (OR 4.2, 9 5% CI 1.4-13.1), chorioamnionitis (OR 4.4, 95% CI 1.2-16.1), and endom etritis (OR 6.4, 95% CI 1.2-34.2). Conclusion: Through the use of mult ivariate modeling, we determined that chorioamnionitis or endometritis , preterm delivery, group B streptococcal colonization, and a prolonge d duration of internal monitoring are independent risk factors for neo natal sepsis. We postulate that the presence of a foreign body that tr averses the birth canal may facilitate ascending peripartal infection.