Objective: To assess the role of intrapartum fever in identifying asymptomatic term neonates with early-onset neonatal sepsis.
Study Design: Retrospective review of all term neonates with sepsis over a 7-year period to evaluate the significance of symptoms at delivery and intrapartum sepsis risks factors in identifying neonates with sepsis.
Results: Fifty-three of 90 term neonates with sepsis (59%) were asymptomatic at delivery. Thirty-five of 53 asymptomatic term neonates (66%) met criteria for sepsis evaluations and 18 (34%) were evaluated when symptoms developed after delivery. Among the 35 asymptomatic term neonates meeting criteria for sepsis evaluations, 14 (40%) had evaluations because of intrapartum fever. Thus, 14 of 53 (26%) asymptomatic term neonates with sepsis (30% of GBS sepsis and 11% of non-GBS sepsis) would not have been evaluated if intrapartum fever were ignored.
Conclusion: Over half of term neonates with sepsis were asymptomatic at delivery. Intrapartum fever was helpful in identifying over a quarter of asymptomatic term neonates with sepsis.
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