Newborn Early-Onset Sepsis Guidelines: The Not So Simple Truth.

Abstract

> The truth is rarely pure and never simple. > —Oscar Wilde How can we criticize a guideline when the proof of its success is abundant and evidence-based? One truth is that the Centers for Disease Control and Prevention (CDC) guidelines for preventing perinatal Group B Streptococcal (GBS) disease have been exceptionally successful. Since the guidelines were first introduced 2 decades ago and have now been widely implemented, there has been a dramatic decline in the incidence of early-onset GBS disease in newborns.1,2 The cornerstones of the CDC guidelines are prenatal GBS screening and intrapartum maternal antibiotics.3 As the authors of the current CDC guideline state, early-onset GBS disease in newborns is now “relatively uncommon.”1 But there is 1 aspect of the CDC guideline that many frontline newborn clinicians find frustrating. Just say the 3 short syllables “chorio” and our blood pressures rise. Intra-amniotic infection (chorioamnionitis) is diagnosed clinically by obstetric clinicians …