#55 Neonatal Outcome Amongst Infants Born to Mothers with Chorioamnionitis

Abstract

Abstract Background Chorioamnionitis (CA) is an acute infection/inflammation of amnion, chorion membrane of placenta and amniotic fluid associated with maternal and neonatal morbidity and mortality. Intrauterine inflammation or infection or both (Triple I) was recommended by National Institutes of Health to help in the diagnosis of CA. There are no studies correlating maternal intrapartum fever and/or Triple I and neonatal outcomes. Objective: To explore the association between maternal intrapartum fever and/or Triple I and neonatal outcomes. Method This was a retrospective chart review of neonates born at Flushing Hospital Medical Center from Nov 2012 to Jan 2020 with maternal intrapartum fever and gestational age (GA) >35 wks. Maternal data extracted from EHR include age, parity, ethnicity, comorbidities (diabetes mellitus, hypertension, and obesity), mode of delivery, duration of ruptured membranes (ROM), Group B streptococcus (GBS) status, Triple I, placenta pathology, first antibiotic dose to time of delivery, time interval from fever to delivery, and highest fever (Tmax). Newborn data extracted from EHR include gender, GA, birth weight (BW), Apgar score <5 at 1 minute, need for resuscitation, hyperbilirubinemia requiring phototherapy, and cultures. Sepsis ruled in (SRI) group included neonates treated with antibiotics for ≥ 7 days and sepsis ruled out (SRO) group included neonates if antibiotics discontinued after 48 hours of negative cultures. Data were analyzed using SPSS, p<0.05 was considered significant. Results Of 275 charts reviewed, 49 (18%) were in SRI and 226 (82%) in SRO. SRI and SRO for maternal age, parity, ethnicity, maternal comorbidities, mode of delivery, duration of ruptured membranes, GBS status, Triple I, placenta pathology, time of first dose of antibiotic to time of delivery, and time from fever to delivery were not significant. Maternal Tmax was significantly higher in SRI group, Table 1. Neonates in SRI and SRO for gender, GA, Apgar score ≤5 at one minute, BW, and hyperbilirubinemia were not significant. Need for resuscitation was significant for SRI neonates, Table 2. No neonate was readmitted or died due to early onset sepsis. Conclusion In our small sample, higher maternal Tmax correlated with SRI and SRI neonates were significantly more likely to require resuscitation. No neonate in either group was readmitted or died within seven days.