Looking for Infection Risks During Birth

Infections in mothers while giving birth increased the risk of infection in newborns

(RxWiki News) Giving birth is an amazing experience, but it's not walk in the park. A mother having an infection around the time of giving birth can raise the stakes for both mother and baby as well.

A recent study found that newborns were considerably more likely to develop an infection if their mothers had a bacterial infection around the time of giving birth.

Even if the mothers did not have symptoms of an infection, their newborns were at risk if the mothers had bacteria colonized in their genital or reproductive areas.

It's not clear whether giving babies antibiotics when mothers have infections would be recommended. More research is needed to find out.

"Attend all prenatal appointments."

This study, led by Grace Chan, MD, of Johns Hopkins Bloomberg School of Public Health in Maryland, looked for risk factors for infections in newborns.

The researchers searched six medical research databases for all studies that involved pregnant women who had infections while giving birth and their newborns with infections.

They identified 83 studies published between January 1, 1960 and March 30, 2013, though seven of these studies came from areas with high infant death rates.

The studies were very different from one another, but the researchers attempted to combine the data as much as possible to establish babies' risk for getting infections.

For newborns of mothers who had an infection confirmed by lab results, the children's odds for developing an infection themselves were more than six times greater than if the mothers did not have an infection.

These lab-confirmed infections included bacteremia, amnionitis, urinary tract infections or chorioamnionitis.

Bacteremia refers to bacteria in the blood. Amnionitis is an infection in the uterus or amniotic sac. Chorioamnionitis is an inflammation of the fetal membranes.

The researchers also looked at the risk of infection for newborns when their mothers had bacterial colonization.

Colonization means the mother tested positive for having bacterial cultures growing in her genital area or reproductive tract even though she didn't have symptoms of infection.

For infants of these mothers, the odds of getting an infection were about nine times greater than if the mothers did not have colonization.

Newborns were about twice as likely to develop an infection if the mother's water broke before she entered labor, if her baby was born before 37 weeks of pregnancy or if her water took a long time to break, as compared to babies whose mothers did not have these risk factors.

The researchers concluded that newborns' risk of infection in the first week of life was considerably greater if the mother suffered from an infection or had bacterial colonization.

Andre Hall, MD, an OBGYN at Birth and Women's Care, PA in Fayetteville, NC, said that limiting neonatal infections remains a goal of both the obstetric and pediatric communities.

"To date, our greatest defense against neonatal infections and particularly neonatal sepsis is regular prenatal visits in which maternal testing is done for infections," Dr. Hall said. "In the event infections are noted, prompt treatment is required, and, in instances, treatment in labor might be required."

"These medical records are then available to the pediatric team in order to treat babies where needed," Dr. Hall added. "This remains our best defense against neonatal infections and a primary reason regular prenatal care is so important."

The authors suggested further research into whether giving newborns antibiotics if their mothers have infections would help prevent the newborns from developing infections.

This study was published August 20 in the journal PLOS Medicine. The authors declared no conflicts of interest.

The research was funded by the National Center for Research Resources at the National Institute of Health and the NIH Roadmap for Medical Research.

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Review Date: 
August 20, 2013