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Objective <p>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.</p> Methods <p>Preterm neonates (≤ 34&#xa0;weeks) were enrolled into: <i>Group A</i> (no IAE; n = 282), <i>Group B</i> (IAE &lt; 24&#xa0;h; n = 204) and <i>Group C</i> (IAE ≥ 24&#xa0;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.</p> Results <p>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, <i>P</i><sub>trends</sub> &lt; 0.001), but its proportion among all EONS did not. Culture-positive LONS incidence declined (<i>P</i><sub>trends</sub> = 0.038). The proportion of culture-negative LONS among all LONS increased (<i>P</i><sub>trends</sub> = 0.024). Threshold values of 13.5&#xa0;h and 4.5&#xa0;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.</p> Conclusions <p>Duration of IAE is not independently associated with increased incidence of culture-negative EONS or any LONS.</p>

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

  • 期刊论文

  • 发表日期：

    2025年8月6日

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

摘要

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, Ptrends < 0.001), but its proportion among all EONS did not. Culture-positive LONS incidence declined (Ptrends = 0.038). The proportion of culture-negative LONS among all LONS increased (Ptrends = 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.