Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.

<h4>Background</h4>Neonatal infections cause a significant proportion of deaths in the first week of life, yet little is known about risk factors and pathways of transmission for early-onset neonatal sepsis globally. We aimed to estimate the risk of neonatal infection (excluding sexually...

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Autores principales:	Grace J Chan, Anne C C Lee, Abdullah H Baqui, Jingwen Tan, Robert E Black
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/1db5170079bb42869dbd9397e178f3db
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spelling	oai:doaj.org-article:1db5170079bb42869dbd9397e178f3db2021-11-18T05:43:10ZRisk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.1549-12771549-167610.1371/journal.pmed.1001502https://doaj.org/article/1db5170079bb42869dbd9397e178f3db2013-08-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23976885/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Neonatal infections cause a significant proportion of deaths in the first week of life, yet little is known about risk factors and pathways of transmission for early-onset neonatal sepsis globally. We aimed to estimate the risk of neonatal infection (excluding sexually transmitted diseases [STDs] or congenital infections) in the first seven days of life among newborns of mothers with bacterial infection or colonization during the intrapartum period.<h4>Methods and findings</h4>We searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, and the World Health Organization Regional Databases for studies of maternal infection, vertical transmission, and neonatal infection published from January 1, 1960 to March 30, 2013. Studies were included that reported effect measures on the risk of neonatal infection among newborns exposed to maternal infection. Random effects meta-analyses were used to pool data and calculate the odds ratio estimates of risk of infection. Eighty-three studies met the inclusion criteria. Seven studies (8.4%) were from high neonatal mortality settings. Considerable heterogeneity existed between studies given the various definitions of laboratory-confirmed and clinical signs of infection, as well as for colonization and risk factors. The odds ratio for neonatal lab-confirmed infection among newborns of mothers with lab-confirmed infection was 6.6 (95% CI 3.9-11.2). Newborns of mothers with colonization had a 9.4 (95% CI 3.1-28.5) times higher odds of lab-confirmed infection than newborns of non-colonized mothers. Newborns of mothers with risk factors for infection (defined as prelabour rupture of membranes [PROM], preterm <37 weeks PROM, and prolonged ROM) had a 2.3 (95% CI 1.0-5.4) times higher odds of infection than newborns of mothers without risk factors.<h4>Conclusions</h4>Neonatal infection in the first week of life is associated with maternal infection and colonization. High-quality studies, particularly from settings with high neonatal mortality, are needed to determine whether targeting treatment of maternal infections or colonization, and/or prophylactic antibiotic treatment of newborns of high risk mothers, may prevent a significant proportion of early-onset neonatal sepsis. Please see later in the article for the Editors' Summary.Grace J ChanAnne C C LeeAbdullah H BaquiJingwen TanRobert E BlackPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 10, Iss 8, p e1001502 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Grace J Chan Anne C C Lee Abdullah H Baqui Jingwen Tan Robert E Black Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.
description	<h4>Background</h4>Neonatal infections cause a significant proportion of deaths in the first week of life, yet little is known about risk factors and pathways of transmission for early-onset neonatal sepsis globally. We aimed to estimate the risk of neonatal infection (excluding sexually transmitted diseases [STDs] or congenital infections) in the first seven days of life among newborns of mothers with bacterial infection or colonization during the intrapartum period.<h4>Methods and findings</h4>We searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, and the World Health Organization Regional Databases for studies of maternal infection, vertical transmission, and neonatal infection published from January 1, 1960 to March 30, 2013. Studies were included that reported effect measures on the risk of neonatal infection among newborns exposed to maternal infection. Random effects meta-analyses were used to pool data and calculate the odds ratio estimates of risk of infection. Eighty-three studies met the inclusion criteria. Seven studies (8.4%) were from high neonatal mortality settings. Considerable heterogeneity existed between studies given the various definitions of laboratory-confirmed and clinical signs of infection, as well as for colonization and risk factors. The odds ratio for neonatal lab-confirmed infection among newborns of mothers with lab-confirmed infection was 6.6 (95% CI 3.9-11.2). Newborns of mothers with colonization had a 9.4 (95% CI 3.1-28.5) times higher odds of lab-confirmed infection than newborns of non-colonized mothers. Newborns of mothers with risk factors for infection (defined as prelabour rupture of membranes [PROM], preterm <37 weeks PROM, and prolonged ROM) had a 2.3 (95% CI 1.0-5.4) times higher odds of infection than newborns of mothers without risk factors.<h4>Conclusions</h4>Neonatal infection in the first week of life is associated with maternal infection and colonization. High-quality studies, particularly from settings with high neonatal mortality, are needed to determine whether targeting treatment of maternal infections or colonization, and/or prophylactic antibiotic treatment of newborns of high risk mothers, may prevent a significant proportion of early-onset neonatal sepsis. Please see later in the article for the Editors' Summary.
format	article
author	Grace J Chan Anne C C Lee Abdullah H Baqui Jingwen Tan Robert E Black
author_facet	Grace J Chan Anne C C Lee Abdullah H Baqui Jingwen Tan Robert E Black
author_sort	Grace J Chan
title	Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.
title_short	Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.
title_full	Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.
title_fullStr	Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.
title_full_unstemmed	Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.
title_sort	risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/1db5170079bb42869dbd9397e178f3db
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Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.

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