The Need for Antibiotics for Neonates Born at 35 Weeks or Later to Mothers Diagnosed with Clinical Chorioamnionitis

Abstract

 Chorioamnionitis（CAM）is associated with an increased risk of neonatal infections. Following the recommendations of the American Academy of Pediatrics（AAP）, antibiotics had been administered to all neonates born to mothers diagnosed with clinical CAM（cCAM）in our institution since 2012. However, recent reports suggest that asymptomatic neonates born to mothers diagnosed with cCAM have a low risk of early-onset sepsis and may not require antibiotics. We retrospectively investigated 118 neonates born at ≥35 weeks’ gestation and weighing ≥2,000g from cCAM-diagnosed mothers between January 2016 and September 2022. To determine the necessity of antibiotic administration, a comparative analysis was conducted between the symptomatic and asymptomatic neonates. Blood culture was positive in one symptomatic case. The perinatal data of the neonates in this study were applied to the three management approach proposed by the AAP in 2019 for infants born to mothers with cCAM. As a result, two of these approaches indicated that antibiotics were unnecessary in over 98% of the asymptomatic cases.