Abstract
Objective: To investigate changes in the etiologic microorganisms causing early-onset neonatal sepsis (EONS) in preterm labor (PTL) or preterm premature rupture of membranes (pPROM) cases over the past 16 years and to analyze the associated factors.
Methods: We included consecutive singleton pregnancies delivered before 34 weeks due to PTL or pPROM. The etiologic microorganisms causing EONS in PTL and pPROM cases were compared between period 1 (1996–2004) and period 2 (2005–2012).
Results: There was no difference in the incidence of Gram-positive bacteria causing EONS between period 1 and 2, either in PTL (2.0% versus 2.1%, p = 1.0) or in pPROM (1.5% versus 1.6%, p = 1.0). However, the incidence of EONS caused by Gram-negative bacteria was significantly increased in pPROM (0.6% versus 2.7%, p = 0.040) during period 2, compared to period 1; but not in PTL (0.3% versus 1.2%, p = 0.211). Multivariable analysis revealed that a prolonged ROM-to-delivery interval (>7 d) was significantly associated with EONS caused by Gram-negative bacteria in pPROM (odds ratio: 6.6, 95% confidence interval: 1.4–31.8, p = 0.018).
Conclusions: The etiologic microorganisms causing EONS have changed over the past 16 years in pPROM cases but not in PTL cases.
Declaration of interest
The authors report no declaration of interest.
Supplementary information available online
Supplemental Table 1.
Notes
* This article was presented at the 34th Annual Meeting of the Society for Maternal-Fetal Medicine, New Orleans, Louisiana, February 3–8, 2014 (abstract #509).