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Conservative management of newborns with 35 weeks or more of gestational age at risk for early-onset sepsis: a Brazilian cohort study.
Camargo, Juliana F; Almeida, Juliana L; Fernandes, Lívia F; Marba, Sergio Tadeu M; Caldas, Jamil Pedro S.
Afiliação
  • Camargo JF; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil. Electronic address: julifc@unicamp.br.
  • Almeida JL; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
  • Fernandes LF; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
  • Marba STM; Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
  • Caldas JPS; Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
J Pediatr (Rio J) ; 99(2): 181-186, 2023.
Article em En | MEDLINE | ID: mdl-36183743
OBJECTIVE: To evaluate the conservative management of newborns born at ≥35 weeks of gestational age, at risk for early-onset neonatal sepsis (EOS). METHODS: Retrospective, analytic cohort study (2016 to 2019), including newborns ≥35 weeks of gestational at risk of EOS, asymptomatic at birth, managed conservatively in full rooming-in: serial physical examination and clinical observation for at least 48 h. They were classified into three groups, according to the clinical course: asymptomatic (group A), symptomatic for other reasons (group B), and with sepsis (group C). Risk factors, clinical signs and differential diagnoses of sepsis, length of stay, and discharge conditions were evaluated. RESULTS: The authors evaluated 769 asymptomatic newborns at risk of EOS. (mean birth weight 2999 ± 485 g and gestational age 37.6 ± 1.7 weeks, respectively) corresponding to 12.2% of rooming-in admissions. The most prevalent risk factors were colonization by Group B Streptococcus (29%), prolonged rupture membrane duration (21.9%) and preterm labor (21.4%). Most of all of them (53.9%) remained asymptomatic (group A). Group B corresponded for 45.3%, and the most common clinical signs were hypothermia (24.5%), tremors (8.7%) and vomiting (8%). Environmental dysthermia (50.7%), prematurity (20.0%), and feeding intolerance (15.7%) were common in Group B. Laboratory tests were performed in 3.5%. Five patients (one confirmed) comprised group C (0.8/1,000 live births). There were no deaths. The median length of stay was 64 h (IQR 50-93). CONCLUSION: The rate of clinical/confirmed EOS was low. Most of the symptomatic patients only needed clinical evaluation to rule out sepsis. Management was shown to be safe.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sepse / Sepse Neonatal / Doenças do Recém-Nascido Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans / Infant / Newborn País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Pediatr (Rio J) Ano de publicação: 2023 Tipo de documento: Article País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sepse / Sepse Neonatal / Doenças do Recém-Nascido Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Humans / Infant / Newborn País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Pediatr (Rio J) Ano de publicação: 2023 Tipo de documento: Article País de publicação: Brasil