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  • Quality Improvement Article
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Quality Improvement

Management of asymptomatic neonates born in the setting of chorioamnionitis: a safety comparison of the well-baby and intensive care setting

Journal of Perinatology volume 37, pages 1236–1241 (2017)Cite this article

Subjects

Abstract

Background:

Evaluate the safety of a change in care setting for asymptomatic neonates born to mothers with chorioamnionitis from the neonatal intensive care unit to the well baby nursery.

Local problem:

The neonatal intensive care unit evaluation and management of babies born to mothers with chorioamionitis often involves separation of the mother-baby dyad and more invasive interventions.

Methods:

A single-center pre/post-intervention study of neonates born from January 2011 to November 2016, comparing safety outcomes in the neonatal intensive care unit (pre-intervention) and well baby nursery (post-intervention), following initiation of a triage protocol.

Interventions:

A protocolized, systematic change was done in the practice location.

Results:

Groups were similar for time to first antibiotic administration, sepsis symptom development and positive blood cultures. Length of stay (median 73.5 vs 64.4 h, P=0.0192) and % of neonates with intravenous fluid exposure (50.4% vs 7.6%, P<0.0001) were lower in the post-intervention group. Exclusive breastfeeding rates improved (pre—7.3% vs post—46.1%, P<0.0001).

Conclusions:

Asymptomatic neonates born to mothers with chorioamnionitis were safely treated in a well baby nursery under the guidance of a protocol for triage, thereby reducing NICU exposure for these neonates.

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Authors and Affiliations

  1. University of Maryland School of Medicine, Office of Student Affairs, Baltimore, MD, USA

    D Peterson

  2. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA

    S B Hoffman, D El-Metwally, M Martino-Gomez, D R Chinta & C Hughes Driscoll

  3. Pediatrics Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

    D El-Metwally

Authors
  1. D Peterson
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  2. S B Hoffman
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  3. D El-Metwally
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  4. M Martino-Gomez
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  5. D R Chinta
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  6. C Hughes Driscoll
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Corresponding author

Correspondence to C Hughes Driscoll.

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Peterson, D., Hoffman, S., El-Metwally, D. et al. Management of asymptomatic neonates born in the setting of chorioamnionitis: a safety comparison of the well-baby and intensive care setting. J Perinatol 37, 1236–1241 (2017). https://doi.org/10.1038/jp.2017.120

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  • DOI: https://doi.org/10.1038/jp.2017.120

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