The risk of early-onset bacterial sepsis for a preterm neonate can be determined by the circumstances around the birth. Culture collection and antibiotic therapy can be adjusted based on risk level.
The neonate is at low risk if all of the following are present:
(1) Cesarean delivery
(2) maternal noninfectious disease or placental insufficiency
(3) absence of labor, attempts to induce labor or premature rupture of membranes
(4) absence of chorioamnionitis on placental pathologic examination
The neonate is at high risk if any of the following are present:
(1) maternal cervical incompetence
(2) preterm labor
(3) premature rupture of the membranes
(4) clinical concern for intra-amniotic infection
(5) acute onset of unexplained, non-reassuring fetal status
A neonate not meeting the criteria for either group would be intermediate risk.
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