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Table 2 EOS risk categories for neonates born at ≥34 weeks’ GA

From: Early-onset sepsis risk calculator: a review of its effectiveness and comparative study with our evidence-based local guidelines

EOS risk categories

Included patients

High-risk patients

≥ 34 weeks’ GA neonates with birth weight ≤ 1500 g

34–36 weeks’ GA neonates with suspected intraamniotic infection

≥ 34 weeks’ GA neonates with three clinical signs of EOS

≥ 34 weeks’ GA neonates with two clinical signs and one risk factor for EOS

Medium-risk patients

34 weeks’ GA neonates without suspicion of intraamniotic infection

≥ 35 weeks’ GA neonates from mothers with previous infant affected by invasive GBS disease and inadequate IAPa

≥ 35 weeks’ GA neonates from mothers with GBS bacteriuria during any trimester of the current pregnancy and inadequate IAP (not if a cesarean delivery is performed before onset of labor on a woman with intact amniotic membranes)a

≥ 35 weeks’ GA neonates from mothers with positive GBS vaginal-rectal screening culture within 5 weeks before delivery and inadequate IAP (not if a cesarean delivery is performed before onset of labor on a woman with intact amniotic membranes)a

35–36 weeks’ GA neonates with unknown GBS maternal status at the onset of labor and inadequate IAP (not if a cesarean delivery is performed before onset of labor on a woman with intact amniotic membranes)a

≥ 35 weeks’ GA neonates from mothers with amniotic membrane rupture ≥18 h and inadequate IAPa

35–36 weeks’ GA neonates from mothers with intrapartum temperature ≥ 38.0 °C

≥ 37 weeks’ GA neonates with suspected intraamniotic infection and inadequate IAPa

≥ 37 weeks’ GA neonates with maternal intrapartum temperature ≥ 38.0 °C and inadequate IAPa

≥ 34 weeks’ GA neonates with one or two clinical indicators of EOS

Low-risk patients

Well-appearing neonates ≥34 weeks’ GA with no risk factors for EOS

  1. aScreening for vaginal-rectal GBS colonization and use of IAP are based on CDC 2010 guidelines [5]; however, at our institution, intrapartum intravenous ampicillin or cefazolin (1 g every 8 h until delivery) is also administered in case of amniotic membrane rupture ≥18 h and negative vaginal-rectal screening culture. IAP is considered adequate when intravenous penicillin, ampicillin or cefazolin is administered ≥4 h before delivery, in accordance with CDC 2010 guidelines [5]
  2. EOS Early-onset sepsis, GA Gestational age, GBS Group B Streptococcus, IAP Intrapartum antibiotic prophylaxis