This site is intended for healthcare professionals

Sign in
Go to /sign-in page

You can view 5 more pages without signing in

Risk factors for and clinical indicators of possible early-onset neonatal infection

Authoring team

Risk factors for and clinical indicators of possible early-onset neonatal infection

Before birth

  • for women in labour, identify and assess any risk factors for early-onset neonatal infection

Box 1 Risk factors for early-onset neonatal infection, including 'red flags'

Red flag risk factor:

  • Suspected or confirmed infection in another baby in the case of a multiple pregnancy.

Other risk factors:

  • Invasive group B streptococcal infection in a previous baby or maternal group B streptococcal colonisation, bacteriuria or infection in the current pregnancy.

 

  • Pre-term birth following spontaneous labour before 37 weeks' gestation.

 

  • Confirmed rupture of membranes for more than 18 hours before a pre-term birth.

 

  • Confirmed prelabour rupture of membranes at term for more than 24 hours before the onset of labour.

 

  • Intrapartum fever higher than 38°C if there is suspected or confirmed bacterial infection.

 

  • Clinical diagnosis of chorioamnionitis.
  • throughout labour, monitor for any new risk factors

Box 2 Clinical indicators of possible early-onset neonatal infection (observations and events in the baby), including 'red flags'

Red flag clinical indicators:

  • Apnoea (temporary stopping of breathing)

 

  • Seizures

 

  • Need for cardiopulmonary resuscitation

 

  • Need for mechanical ventilation

 

  • Signs of shock

Other clinical indicators:

  • Altered behaviour or responsiveness

 

  • Altered muscle tone (for example, floppiness)

 

  • Feeding difficulties (for example, feed refusal)

 

  • Feed intolerance, including vomiting, excessive gastric aspirates and abdominal distension

 

  • Abnormal heart rate (bradycardia or tachycardia)

 

  • Signs of respiratory distress (including grunting, recession, tachypnoea)

 

  • Hypoxia (for example, central cyanosis or reduced oxygen saturation level)

 

  • Persistent pulmonary hypertension of newborns

 

  • Jaundice within 24 hours of birth

 

  • Signs of neonatal encephalopathy

 

  • Temperature abnormality (lower than 36°C or higher than 38°C) unexplained by environmental factors

 

  • Unexplained excessive bleeding, thrombocytopenia, or abnormal coagulation

 

  • Altered glucose homeostasis (hypoglycaemia or hyperglycaemia)

 

  • Metabolic acidosis (base deficit of 10 mmol/litre or greater)

For detailed guidance then see NICE: Neonatal infection: antibiotics for prevention and treatment

Reference:

Related pages

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.