Characteristics of Extremely Premature Infants at Low Risk for Sepsis

Extremely premature infants are vulnerable and clinically unstable after birth. Concern about sepsis leads to early, and often repeated, exposure to antibiotics. Researchers assessed whether birth history characteristics could be used to identify extremely preterm infants at low risk for early-onset sepsis. The study included 15,433 infants born at 22 to 28 weeks gestational age over an 8-year period at Neonatal Research Network centers. Infants born weighing less than 401 g or with congenital anomalies were excluded.

Low-risk criteria were selected a priori and included cesarean delivery, rupture of membrane at delivery, and no maternal clinical chorioamnionitis. Overall, 37% of infants were classified as low risk, with the remaining 63% se…