Depression at birth in term infants exposed to maternal chorioamnionitis: Does neonatal fever play a role?

Lina F. Shalak, Jeffrey M. Perlman, Gregory L. Jackson, Abbot R. Laptook

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives: (1) To determine the incidence and the time course of elevated temperature following delivery in term infants with clinical chorioamnionitis (CHORIO) and (2) to determine if the extent of temperature elevation at birth is associated with increased likelihood of NICU Admissions, birth depression, or with short-term neurological abnormalities. Design/methods: The infants were divided into two groups based on the median admission rectal temperature of 37.8°C for the cohort. Depression at birth was defined as either the need of positive pressure ventilation for >2 minutes, intubation, or Apgar score <6 at 5 minutes. Neurological examination and assessment of encephalopathy (Sarnat staging) was performed at birth and daily thereafter, by one investigator blinded to temperature findings. Results: Infants with higher rectal temperature at 30 minutes of life were more likely to be admitted to NICU: OR (2.8, 95% confidence interval (CI) [1.8 to 4.3], and were more likely to have birth depression OR (3.95%CI [1.4 to 6.5]). For infants in NICU, a rectal temperature above 37.8°C was present in 87% in the delivery room, persisted in 47% at 30 minutes, and declined to a normal temperature at 60 minutes of life in the absence of medical interventions. There was no relationship between neurological scores and neonatal temperature. Conclusions: Term infants exposed to CHORIO who had a higher neonatal temperature at 30 minutes of life, were more likely to be admitted to the NICU and to have birth depression, than infants with lesser degree of temperature elevation after birth. Within the NICU group, the extent of temperature elevation was not associated with worse neurological outcomes.

Original languageEnglish (US)
Pages (from-to)447-452
Number of pages6
JournalJournal of Perinatology
Volume25
Issue number7
DOIs
StatePublished - Jul 2005

Fingerprint

Chorioamnionitis
Fever
Mothers
Parturition
Temperature
Confidence Intervals
Delivery Rooms
Apgar Score
Positive-Pressure Respiration
Neurologic Examination
Brain Diseases
Intubation
Research Personnel

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Depression at birth in term infants exposed to maternal chorioamnionitis : Does neonatal fever play a role? / Shalak, Lina F.; Perlman, Jeffrey M.; Jackson, Gregory L.; Laptook, Abbot R.

In: Journal of Perinatology, Vol. 25, No. 7, 07.2005, p. 447-452.

Research output: Contribution to journalArticle

Shalak, Lina F. ; Perlman, Jeffrey M. ; Jackson, Gregory L. ; Laptook, Abbot R. / Depression at birth in term infants exposed to maternal chorioamnionitis : Does neonatal fever play a role?. In: Journal of Perinatology. 2005 ; Vol. 25, No. 7. pp. 447-452.
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title = "Depression at birth in term infants exposed to maternal chorioamnionitis: Does neonatal fever play a role?",
abstract = "Objectives: (1) To determine the incidence and the time course of elevated temperature following delivery in term infants with clinical chorioamnionitis (CHORIO) and (2) to determine if the extent of temperature elevation at birth is associated with increased likelihood of NICU Admissions, birth depression, or with short-term neurological abnormalities. Design/methods: The infants were divided into two groups based on the median admission rectal temperature of 37.8°C for the cohort. Depression at birth was defined as either the need of positive pressure ventilation for >2 minutes, intubation, or Apgar score <6 at 5 minutes. Neurological examination and assessment of encephalopathy (Sarnat staging) was performed at birth and daily thereafter, by one investigator blinded to temperature findings. Results: Infants with higher rectal temperature at 30 minutes of life were more likely to be admitted to NICU: OR (2.8, 95{\%} confidence interval (CI) [1.8 to 4.3], and were more likely to have birth depression OR (3.95{\%}CI [1.4 to 6.5]). For infants in NICU, a rectal temperature above 37.8°C was present in 87{\%} in the delivery room, persisted in 47{\%} at 30 minutes, and declined to a normal temperature at 60 minutes of life in the absence of medical interventions. There was no relationship between neurological scores and neonatal temperature. Conclusions: Term infants exposed to CHORIO who had a higher neonatal temperature at 30 minutes of life, were more likely to be admitted to the NICU and to have birth depression, than infants with lesser degree of temperature elevation after birth. Within the NICU group, the extent of temperature elevation was not associated with worse neurological outcomes.",
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