TABLE 2.
Maternal Characteristics of Deliveries Producing Newborns With Culture-Confirmed, Early-Onset Infections Born to Women With Chorioamnionitis, 2006–2009, Overall and by Gestational Age
| Characteristic | All Infants (N = 229) | Gestational Age of Newborn | P | |
|---|---|---|---|---|
| Preterm (22–36 Weeks) (n = 148) |
Term (≥37 Weeks) (n = 81) |
|||
| Age, median (range), y | 26 (15–41) | 28 (15–41) | 24 (15–39) | .002 |
| Chorioamnionitis, n (%) | .001 | |||
| Clinical and histologic | 110 (48) | 76 (51) | 34 (42) | |
| Histologic only | 77 (34) | 55 (37) | 22 (27) | |
| Clinical only | 42 (18) | 17 (11) | 25 (31) | |
| At least 1 GBS risk factor,a n (%) | 202 (89) | 148 (100) | 54 (68) | <.001 |
| At least 1 GBS risk factor (excluding delivery <37 weeks), n (%) | 149 (65) | 95 (64) | 54 (68) | .66 |
| Clinical symptoms of chorioamnionitis in the 72 hours before delivery, n (%) | ||||
| Maternal feverb | 87 (38) | 38 (26) | 49 (60) | <.001 |
| Uterine or abdominal tenderness | 52 (23) | 46 (31) | 6 (7) | <.001 |
| Foul-smelling discharge or amniotic fluid | 35 (15) | 27 (18) | 8 (10) | .12 |
| Maternal tachycardia (>100 beats per minute) | 96 (42) | 62 (42) | 34 (42) | .99 |
| At least 1 clinical sign above | 162 (71) | 100 (68) | 62 (77) | .17 |
| Maternal fever alone | 30 (13) | 6 (4) | 24 (30) | <.001 |
| IAP exposure, n (%) | 159 (69) | 111 (75) | 48 (59) | .02 |
| IAP agent,c n (%) | ||||
| Ampicillin | 123 (54) | 85 (57) | 38 (47) | .13 |
| Penicillin G | 18 (8) | 17 (11) | 1 (1) | .004 |
| Gentamicin | 73 (32) | 39 (26) | 34 (42) | .02 |
| Clindamycin | 11 (5) | 7 (5) | 4 (5) | 1.0 |
| Erythromycin | 42 (18) | 42 (28) | 0 (0) | <.001 |
| Other | 60 (26) | 52 (35) | 8 (10) | <.001 |
Maternal GBS risk factor information was missing for 1 term infant; the timing of IAP exposure was missing for 6 preterm infants. P values for a test of whether the characteristic differed by gestational age were derived by Fisher’s exact test (categorical variables) or Kruskal-Wallis test (maternal age).
GBS risk factors were as follows: previous infant with GBS infection, GBS bacteriuria, rupture of membranes ≥18 hours before delivery, delivery at <37 weeks’ gestation, and intrapartum fever defined as a temperature ≥100.4°F (38.0°C) between onset of labor and delivery.
Maternal fever was defined as any temperature ≥100.4°F (38.0°C) in the 72 hours before delivery without regard to onset of labor.
Of the 159 women who received antibiotics in the 72 hours before and including delivery, 38 (24%) received 1 drug, 76 (48%) received 2 drugs, 29 (18%) received 3 drugs, and 15 (9%) received 4 or 5 drugs; information was missing for 1 woman. For mothers of preterm infants, “other” intrapartum antibiotics included amoxicillin (14 infants), cefazolin (10 infants), ceftriaxone (1 infant), azithromycin (7 infants), metronidazole (2 infants), and other not specified (18 infants). For mothers of term infants, “other” intrapartum antibiotics included cefazolin (4 infants), ceftriaxone (2 infants), azithromycin (1 infant), and vancomycin (1 infant).