Association of delivery risk phenotype with early

Journal of Perinatology (2023)Cite this article

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To determine delivery risk phenotype-specific incidence of early-onset sepsis (EOS) among preterm infants.

Retrospective cohort study of infants born <35 weeks’ gestation at four perinatal centers during 2017–2021. Infants were classified into one of six delivery risk phenotypes incorporating delivery mode, presence of labor, and duration of rupture of membranes (ROM). The primary outcome was EOS incidence within the overall cohort and each risk phenotype.

Among 2937 preterm infants, 21 had EOS (0.7%, or 7.1 cases/1000 preterm infants). The majority of EOS cases (13/21, 62%) occurred in the setting of prolonged ROM ≥ 18 h, with a phenotype incidence of 23.8 cases/1000 preterm infants. There were no EOS cases among infants born by cesarean section without ROM (with or without labor), nor via cesarean section with ROM < 18 h without labor.

Delivery risk phenotyping may inform EOS risk stratification in preterm infants.

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SAC reports receiving research funding from the National Heart, Lung and Blood Institute of the National Institutes of Health (T32HL007891). JT receives research funding from the Michigan Department of Health and Human Services. KJD is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD091365). JDC is supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (K24HL115354). KMP reports receiving research funding from the National Institutes of Health, from two contracts with the Centers for Disease Control and Prevention, and from the Children’s Hospital of Philadelphia.

Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

Sarah A. Coggins, Sagori Mukhopadhyay & Karen M. Puopolo

Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA

Sarah A. Coggins, Sagori Mukhopadhyay, Kevin J. Downes & Karen M. Puopolo

Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

Sarah A. Coggins, Sagori Mukhopadhyay, Kevin J. Downes & Karen M. Puopolo

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA

Jourdan Triebwasser

Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

Kevin J. Downes

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA

Jason D. Christie

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SAC contributed to study design, performed data collection and data analysis, and wrote the manuscript. SM, JDC, and KMP contributed to study design, interpreted the results, and critically reviewed the manuscript. JT and KJD interpreted the results and critically reviewed the manuscript.

Correspondence to Sarah A. Coggins.

The authors declare no competing interests.

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Coggins, S.A., Mukhopadhyay, S., Triebwasser, J. et al. Association of delivery risk phenotype with early-onset sepsis in preterm infants. J Perinatol (2023). https://doi.org/10.1038/s41372-023-01743-z

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Received: 25 May 2023

Revised: 18 July 2023

Accepted: 27 July 2023

Published: 05 August 2023

DOI: https://doi.org/10.1038/s41372-023-01743-z

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