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Arch Iran Med. 2020;23(7): 480-487.
doi: 10.34172/aim.2020.45
  Abstract View: 155
  PDF Download: 78

Original Article

Chorioamnionitis and Neonates; Which Strategy?

Seyyed-Abolfazl Afjeh 1,2 * ORCID logo, Mohammad Kazem Sabzehei 3 ORCID logo, Roxana Mansor Ghanaie 2 ORCID logo, Mahdiyeh Karimizadeh 4 ORCID logo, Ahmad Reza Shamshiri 5 ORCID logo, Fatemeh Esmaili 1

1 Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Pediatrics Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Hamadan University of Medical Sciences, Hamadan, Iran
4 Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Chorioamnionitis (CAM) is one of the major risk factors for neonatal early-onset sepsis (EOS). Different international guidelines have been developed for diagnosis and care of such neonates. This research aimed to evaluate our neonates and compare them with the guidelines.

Methods: This prospective cohort study was conducted during five years (March 2012 to March 2017), and comprised of neonates (any gestational age) born to mothers with CAM (any criteria). The neonates’ clinical findings and interventions were collected and analyzed.

Results: In total, out of 28,988 live born neonates, CAM was found in mothers of 169 neonates (1.7%). Among the studied neonates, 30.8% were born ≤34 week of gestation, 39% had birth weight <2500 g, and 58.6% were asymptomatic. Out of 99 asymptomatic neonates, 47 were observed near mothers and 52 admitted to the neonatal intensive care unit (NICU). The frequency of abnormal tests was 23.07% in asymptomatic vs. 35.7% in symptomatic neonates; three neonates developed culture positive EOS (2.75%) and 68.05% of the neonates received antibiotics. The length of stay was 2.59 ± 1.13 (median = 2.00, IQR = 1.00) days in asymptomatic vs. 15.15 ± 13.67 (median = 7.00, IQR = 15.25) days in symptomatic neonates (P<0.001).

Conclusion: The use of guidelines increased the length of stay, lab tests, and antibiotics in asymptomatic and neonates with negative blood culture. In addition to the mother-neonate separation, these guidelines may increase nosocomial infection, antibiotic resistance, and costs; therefore, new guidelines are needed to be developed.

Keywords: Chorioamnionitis, Neonatal sepsis, Newborn, Prematurity
Cite this article as: Afjeh SA, Sabzehei MK, Mansor Ghanaie R, Karimizadeh M, Shamshiri AR, Esmaili F. Chorioamnionitis and neonates; which strategy? Arch Iran Med. 2020;23(7):480–487. doi: 10.34172/aim.2020.45.
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Submitted: 20 Jul 2019
Accepted: 23 Feb 2020
ePublished: 01 Jul 2020
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