[Bacterial infection of the newborn by maternal fetal contamination: one can depend on the anamnesis]

Abstract

All babies born in a University maternity unit over a period of four months had bacteriological swabs taken in the labour ward. This was to see whether a list of criteria in the history for bacterial infection of the newborn could be relied on. The criteria were: premature rupture of the membranes (before labour had started at all), rupture of the membranes for more than 12 hours, stained liquor, prematurity, fetal tachycardia of more than 160 per minute or abnormal rhythm of the heartbeat, an Apgar score of less than 7 after 1 minute, maternal genital or urinary tract infection (not cured) in month before delivery, maternal temperature above 38 degrees C in labour. During the study there were: 570 live births of which 222 (39%) were at risk of infection according to the above list of criteria, 35 had bacterial colonies present and 4 were definitely infected. More cultures from the placenta, the gastric fluid and the skin came back positive when there was a recognised risk of infection. Both the clinical and bacteriological results show that the risk was 5.24 of colonisation when the risk of infection had been recognised. These prospective results when checked against the retrospective results already obtained in the same department, suggest that this kind of screening for infection is worthwhile without being too expensive, and one can rely on the history to screen for neonatal bacterial infection.