The analysis of bacteriologically negative congenital infections in neonates with regard to the type of labour and intrapartum antibiotic prophylaxis

Aim of the study
To analyse neonates with bacteriologically negative congenital infections with regard to the type of labour and intrapartum antibiotic prophylaxis (IAP).

Material and methods
The research material included the medical history data of 1328 born-alive neonates from single pregnancies, and the data of their mothers. A c2 test (also with Yates correction) was employed to perform fraction analysis. The level of significance was set at p < 0.05.

Results
The neonates with congenital infections were hospitalised for considerably longer than the uninfected ones irrespective of whether they were born vaginally (p < 0.001) or via C-section (p < 0.0007). The uninfected neonates scored significantly higher on the Apgar scale (p < 0.0001). 1.23% of the mothers who did not receive IAP and 3.37% of those who received IAP gave birth to ill neonates. The total percentage of infants with clinically confirmed infections was 1.81% (p = 0.0096). Clinically confirmed congenital infections were found in 1.13% of the neonates from vaginal labours and 4.55% of those born via C-section (p = 0.0001).

Conclusions
Early symptomatic infections in neonates can develop without positive bacteriological culture results. IAP can modify the occurrence and/or the course of clinically confirmed congenital infections. Empirical antibiotic treatment of infections administered during the first 24 hours does not seem to be the best solution; however, currently it is necessary. The colour of amniotic fluid and the type of labour, especially when accompanied by other risk factors, may suggest an infection.