The role of intrapartum fever in identifying asymptomatic term neonates with early-onset neonatal sepsis.

OBJECTIVE

To assess the role of intrapartum fever in identifying asymptomatic term neonates with early-onset neonatal sepsis.

METHODS

Retrospective review of all term neonates with sepsis over a 7-year period to evaluate the significance of symptoms at delivery and intrapartum sepsis risks factors in identifying neonates with sepsis.

RESULTS

Fifty-three of 90 term neonates with sepsis (59%) were asymptomatic at delivery. Thirty-five of 53 asymptomatic term neonates (66%) met criteria for sepsis evaluations and 18 (34%) were evaluated when symptoms developed after delivery. Among the 35 asymptomatic term neonates meeting criteria for sepsis evaluations, 14 (40%) had evaluations because of intrapartum fever. Thus, 14 of 53 (26%) asymptomatic term neonates with sepsis (30% of GBS sepsis and 11% of non-GBS sepsis) would not have been evaluated if intrapartum fever were ignored.

CONCLUSIONS

Over half of term neonates with sepsis were asymptomatic at delivery. Intrapartum fever was helpful in identifying over a quarter of asymptomatic term neonates with sepsis.