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Risk of Early-Onset Neonatal Infection with Maternal Infection or Colonization: A Global Systematic Review and Meta-Analysis

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  • Grace J Chan
  • Anne CC Lee
  • Abdullah H Baqui
  • Jingwen Tan
  • Robert E Black

Abstract

: Grace Chan and coauthors conducted a systematic review and meta-analysis of studies evaluating the risk of neonatal infection or colonization during the first seven days of life among newborns of mothers with bacterial infection or colonization during the intrapartum period. Background: Neonatal infections cause a significant proportion of deaths in the first week of life, yet little is known about risk factors and pathways of transmission for early-onset neonatal sepsis globally. We aimed to estimate the risk of neonatal infection (excluding sexually transmitted diseases [STDs] or congenital infections) in the first seven days of life among newborns of mothers with bacterial infection or colonization during the intrapartum period. Methods and Findings: We searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, and the World Health Organization Regional Databases for studies of maternal infection, vertical transmission, and neonatal infection published from January 1, 1960 to March 30, 2013. Studies were included that reported effect measures on the risk of neonatal infection among newborns exposed to maternal infection. Random effects meta-analyses were used to pool data and calculate the odds ratio estimates of risk of infection. Eighty-three studies met the inclusion criteria. Seven studies (8.4%) were from high neonatal mortality settings. Considerable heterogeneity existed between studies given the various definitions of laboratory-confirmed and clinical signs of infection, as well as for colonization and risk factors. The odds ratio for neonatal lab-confirmed infection among newborns of mothers with lab-confirmed infection was 6.6 (95% CI 3.9–11.2). Newborns of mothers with colonization had a 9.4 (95% CI 3.1–28.5) times higher odds of lab-confirmed infection than newborns of non-colonized mothers. Newborns of mothers with risk factors for infection (defined as prelabour rupture of membranes [PROM], preterm

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  • Grace J Chan & Anne CC Lee & Abdullah H Baqui & Jingwen Tan & Robert E Black, 2013. "Risk of Early-Onset Neonatal Infection with Maternal Infection or Colonization: A Global Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 10(8), pages 1-20, August.
    • Handle: RePEc:plo:pmed00:1001502
    DOI: 10.1371/journal.pmed.1001502
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    Cited by:

    1. Shruti Murthy & Myron Anthony Godinho & Vasudeva Guddattu & Leslie Edward Simon Lewis & N Sreekumaran Nair, 2019. "Risk factors of neonatal sepsis in India: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-26, April.
    2. Anna A. Usynina & Vitaly Postoev & Jon Øyvind Odland & Andrej M. Grjibovski, 2018. "Adverse Pregnancy Outcomes among Adolescents in Northwest Russia: A Population Registry-Based Study," IJERPH, MDPI, vol. 15(2), pages 1-12, February.
    3. Biruk Beletew Abate & Ayelign Mengesha Kasie & Melese Abate Reta & Mesfin Wudu Kassaw, 2020. "Neonatal sepsis and its associated factors in East Africa: a systematic review and meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(9), pages 1623-1633, December.
    4. Perlinot Herindrainy & Mamitiana Alain Noah Rabenandrasana & Zafitsara Zo Andrianirina & Feno Manitra Jacob Rakotoarimanana & Michael Padget & Agathe de Lauzanne & Awa Ndir & Elsa Kermorvant-Duchemin , 2018. "Acquisition of extended spectrum beta-lactamase-producing enterobacteriaceae in neonates: A community based cohort in Madagascar," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-17, March.

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