Affiliations: [a]
Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
| [b]
Department of Medicine, University of Virginia, Charlottesville, VA, USA
| [c]
Department of Pediatrics, University of Texas Southwestern, Dallas, TX, USA
Correspondence:
[*]
Address for correspondence: Brynne A. Sullivan, MD, Assistant Professor of Pediatrics, Neonatology, University of Virginia School of Medicine, Department of Pediatrics Box 00386, Hospital Drive, Charlottesville VA 22908, USA. Tel.: +1 434 924 5428; [email protected].
Abstract: BACKGROUND:
Chorioamnionitis and early onset sepsis (EOS) in very low birth weight (VLBW,< 1500 g) infants may cause a systemic inflammatory response reflected in patterns of heart rate (HR) and oxygenation measured by pulse oximetry (SpO2). Identification of these patterns might inform decisions about duration of antibiotic therapy after birth. OBJECTIVE:
Compare early HR and SpO2 patterns in VLBW infants with or without early onset sepsis (EOS) or histologic chorioamnionitis (HC). STUDY DESIGN:
Retrospective study of placental pathology and HR and SpO2 in the first 72 h from birth in relation to EOS status for inborn VLBW NICU patients 2012–2019. RESULT:
Among 362 VLBW infants with HR and SpO2 data available, clinical, or culture-positive EOS occurred in 91/362 (25%) and HC in 81/355 (22%). In univariate analysis, EOS was associated with higher mean HR, lower mean SpO2, and less negative skewness of HR in the first 3 days after birth. HC was associated with higher standard deviation and skewness of HR but no difference in SpO2. In multivariable modeling, significant risk factors for EOS were mean HR, gestational age, HC, mean SpO2, and skewness of SpO2. CONCLUSION:
HR and SpO2 patterns differ shortly after birth in VLBW infants exposed to HC or with EOS, likely reflecting a systemic inflammatory response.
Keywords: Chorioamnionitis, early onset sepsis, heart rate, oxygenation, premature infants, very low birth weight, vital signs
