Abstract
Objective
To determine delivery risk phenotype-specific incidence of early-onset sepsis (EOS) among preterm infants.
Study design
Retrospective cohort study of infants born <35 weeks’ gestation at four perinatal centers during 2017–2021. Infants were classified into one of six delivery risk phenotypes incorporating delivery mode, presence of labor, and duration of rupture of membranes (ROM). The primary outcome was EOS incidence within the overall cohort and each risk phenotype.
Results
Among 2937 preterm infants, 21 had EOS (0.7%, or 7.1 cases/1000 preterm infants). The majority of EOS cases (13/21, 62%) occurred in the setting of prolonged ROM ≥ 18 h, with a phenotype incidence of 23.8 cases/1000 preterm infants. There were no EOS cases among infants born by cesarean section without ROM (with or without labor), nor via cesarean section with ROM < 18 h without labor.
Conclusion
Delivery risk phenotyping may inform EOS risk stratification in preterm infants.
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Data availability
A de-identified dataset may be made available upon reasonable request.
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Funding
SAC reports receiving research funding from the National Heart, Lung and Blood Institute of the National Institutes of Health (T32HL007891). JT receives research funding from the Michigan Department of Health and Human Services. KJD is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD091365). JDC is supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (K24HL115354). KMP reports receiving research funding from the National Institutes of Health, from two contracts with the Centers for Disease Control and Prevention, and from the Children’s Hospital of Philadelphia.
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SAC contributed to study design, performed data collection and data analysis, and wrote the manuscript. SM, JDC, and KMP contributed to study design, interpreted the results, and critically reviewed the manuscript. JT and KJD interpreted the results and critically reviewed the manuscript.
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Coggins, S.A., Mukhopadhyay, S., Triebwasser, J. et al. Association of delivery risk phenotype with early-onset sepsis in preterm infants. J Perinatol 43, 1166–1172 (2023). https://doi.org/10.1038/s41372-023-01743-z
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DOI: https://doi.org/10.1038/s41372-023-01743-z