Management of neonates born to mothers with intra-amniotic infection

Neonates born to mothers with intra-amniotic infection are at increased risk of early-onset sepsis. Following birth, closely observe neonates born to mothers with intrapartum fever (ie 38°C or more during labour), or suspected or confirmed intra-amniotic infection. Some neonates at increased risk of early-onset sepsis require presumptive antibiotic therapy. For women with intrapartum fever, or suspected or confirmed intra-amniotic infection, seek advice from a paediatrician as soon as possible to ensure appropriate postnatal management of the neonate.

In the absence of signs of sepsis or septic shock, term (gestational age 37 weeks’ or older) and late-preterm (gestational age 34 to 36.6 weeks) neonates born to mothers with intrapartum fever or suspected intra-amniotic infection do not routinely need antibiotic therapy, but should be closely observed.

Consider performing investigations (eg full blood count, blood culture) and starting presumptive antibiotic therapy for:

• preterm neonates with a gestational age less than 34 weeks born to mothers with intrapartum fever or suspected intra-amniotic infection
• neonates of any gestational age born to mothers with confirmed intra-amniotic infection.

For presumptive antibiotic therapy of preterm neonates (gestational age younger than 37 weeks) or the treatment of early-onset sepsis or septic shock in preterm neonates, seek expert advice.

For presumptive antibiotic therapy of term neonates or the treatment of early-onset sepsis or septic shock in term neonates, see Early-onset sepsis or septic shock in neonates, source not apparent.