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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Infection in late preterm infants.

Simonetta Picone1, Roberto Aufieri1, Piermichele Paolillo1

  • 1Division of Neonatology and Neonatal Intensive Care, Casilino General Hospital, Roma, Italy.

Early Human Development
|April 9, 2014
PubMed
Summary

Late preterm infants face higher infection risks due to immature immune systems. Key risk factors include umbilical venous catheter use and antenatal corticosteroid exposure, necessitating clinical vigilance for prompt treatment.

Keywords:
BiomarkersCulturesInfectionLate pretermNeonatal sepsis

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Area of Science:

  • Neonatal Medicine
  • Pediatric Infectious Diseases
  • Perinatal Health

Background:

  • Late preterm (LP) infants exhibit heightened susceptibility to infections compared to term infants owing to their less mature immune systems.
  • Limited existing literature addresses the specific risks and incidence of infection and sepsis in LP infants.

Purpose of the Study:

  • To determine the rates of treated infections in moderate and late preterm infants (gestational age 32-36 weeks).
  • To identify significant risk factors associated with infection development in this vulnerable population.

Main Methods:

  • A retrospective analysis was conducted on 771 moderate and late preterm infants admitted between June 2008 and November 2013.
  • Data collection included infection rates, causative pathogens, inflammatory markers (CRP, procalcitonin), and potential risk factors.

Main Results:

  • An overall treated infection incidence of 16.6% was observed, with 90% occurring within the first 72 hours of life.
  • Identified risk factors for infection included umbilical venous catheter insertion, antenatal corticosteroid prophylaxis, and cesarean section birth.
  • Respiratory symptoms were prevalent in a significant majority (78.3%) of infants diagnosed with sepsis.

Conclusions:

  • Moderate and late preterm infants demonstrate a substantially elevated risk of infection compared to their term counterparts.
  • Clinical suspicion and treatment based on presenting symptoms and inflammatory markers are crucial, especially given frequent negative blood cultures.
  • The findings underscore the importance of judicious antibiotic use to prevent overtreatment while managing infection risk in preterm neonates.