Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study
The global evolution of pathogens causing early-onset sepsis (EOS), a critical condition in preterm infants, necessitates a re-evaluation of risk factors to develop updated prevention and treatment strategies. This nationwide case–control study in Taiwan analyzed data from the National Health Insura...
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2025-01-01
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| author | Hao-Yuan Lee Yu-Lung Hsu Wen-Yuan Lee Kuang-Hua Huang Ming-Luen Tsai Chyi-Liang Chen Yu-Chia Chang Hung-Chih Lin |
| author_facet | Hao-Yuan Lee Yu-Lung Hsu Wen-Yuan Lee Kuang-Hua Huang Ming-Luen Tsai Chyi-Liang Chen Yu-Chia Chang Hung-Chih Lin |
| author_sort | Hao-Yuan Lee |
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| description | The global evolution of pathogens causing early-onset sepsis (EOS), a critical condition in preterm infants, necessitates a re-evaluation of risk factors to develop updated prevention and treatment strategies. This nationwide case–control study in Taiwan analyzed data from the National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database from 2010 to 2019. The study included 176,681 mother–child pairs with preterm births. We identified 2942 clinical EOS cases from 5535 diagnosed sepsis cases, excluding unlikely cases. A control group of 14,710 preterm neonates without EOS was selected at a 1:5 ratio. Clinical EOS increased since 2017. Adjusted logistic regression identified significant EOS risk factors in preterm infants, including maternal fever, chorioamnionitis, maternal diabetes mellitus, maternal antibiotic usage, very preterm birth, birth weight (all with <i>p</i> < 0.001), maternal pneumonia (<i>p</i> = 0.002), and maternal CS (<i>p</i> = 0.004). Effective treatment of maternal conditions like diabetes, fever, and infections is essential to prevent EOS in preterm infants. Key measures include reducing unnecessary antibiotics or steroids, minimizing unnecessary cesarean sections, avoiding premature or prolonged rupture of membranes (PPROM), and increasing gestational age and neonatal birth weight. High-risk preterm neonates should be closely monitored for EOS and considered for antibiotics when warranted. |
| format | Article |
| id | doaj-art-20c27d6df0c5497ea9605e855b004b68 |
| institution | Kabale University |
| issn | 2076-0817 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Pathogens |
| spelling | doaj-art-20c27d6df0c5497ea9605e855b004b682025-01-24T13:44:51ZengMDPI AGPathogens2076-08172025-01-011418910.3390/pathogens14010089Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based StudyHao-Yuan Lee0Yu-Lung Hsu1Wen-Yuan Lee2Kuang-Hua Huang3Ming-Luen Tsai4Chyi-Liang Chen5Yu-Chia Chang6Hung-Chih Lin7Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, No. 79-9, Sha-Luen-Hu, Xi-Zhou Li, Hou-Loung Town, Miaoli 35664, TaiwanDivision of Pediatric Infectious Diseases, China Medical University Children’s Hospital, China Medical University, Taichung 40447, TaiwanDepartment of Neurosurgery, Wei Gong Memorial Hospital, Miaoli 35159, TaiwanDepartment of Health Services Administration, China Medical University, Taichung 40447, TaiwanDivision of Neonatology, China Medical University Children’s Hospital, China Medical University, Taichung 40447, TaiwanMolecular Infectious Disease Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333423, TaiwanDepartment of Long Term Care, College of Health and Nursing, National Quemoy University, No. 1, University Road, Jinning Township, Kinmen County 892009, TaiwanDivision of Neonatology, China Medical University Children’s Hospital, China Medical University, Taichung 40447, TaiwanThe global evolution of pathogens causing early-onset sepsis (EOS), a critical condition in preterm infants, necessitates a re-evaluation of risk factors to develop updated prevention and treatment strategies. This nationwide case–control study in Taiwan analyzed data from the National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database from 2010 to 2019. The study included 176,681 mother–child pairs with preterm births. We identified 2942 clinical EOS cases from 5535 diagnosed sepsis cases, excluding unlikely cases. A control group of 14,710 preterm neonates without EOS was selected at a 1:5 ratio. Clinical EOS increased since 2017. Adjusted logistic regression identified significant EOS risk factors in preterm infants, including maternal fever, chorioamnionitis, maternal diabetes mellitus, maternal antibiotic usage, very preterm birth, birth weight (all with <i>p</i> < 0.001), maternal pneumonia (<i>p</i> = 0.002), and maternal CS (<i>p</i> = 0.004). Effective treatment of maternal conditions like diabetes, fever, and infections is essential to prevent EOS in preterm infants. Key measures include reducing unnecessary antibiotics or steroids, minimizing unnecessary cesarean sections, avoiding premature or prolonged rupture of membranes (PPROM), and increasing gestational age and neonatal birth weight. High-risk preterm neonates should be closely monitored for EOS and considered for antibiotics when warranted.https://www.mdpi.com/2076-0817/14/1/89early-onset sepsisrisk factorsmaternal infectionsantibiotic and steroid usediabetes mellitus |
| spellingShingle | Hao-Yuan Lee Yu-Lung Hsu Wen-Yuan Lee Kuang-Hua Huang Ming-Luen Tsai Chyi-Liang Chen Yu-Chia Chang Hung-Chih Lin Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study Pathogens early-onset sepsis risk factors maternal infections antibiotic and steroid use diabetes mellitus |
| title | Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study |
| title_full | Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study |
| title_fullStr | Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study |
| title_full_unstemmed | Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study |
| title_short | Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study |
| title_sort | maternal infections antibiotics steroid use and diabetes mellitus increase risk of early onset sepsis in preterm neonates a nationwide population based study |
| topic | early-onset sepsis risk factors maternal infections antibiotic and steroid use diabetes mellitus |
| url | https://www.mdpi.com/2076-0817/14/1/89 |
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