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Association between birth route and late-onset sepsis in very preterm neonates

Journal of Perinatology volume 36, pages 1083–1087 (2016)Cite this article

Subjects

Abstract

Objective:

To evaluate the association between birth route and late-onset sepsis (LOS), and coagulase-negative Staphylococcal (CONS)-related LOS in preterm neonates.

Study Design:

In this observational study, data from 20,038 infants born between 22 and 32 weeks’ gestation and admitted to Canadian neonatal intensive care units between 2010 and 2014 were analyzed retrospectively. The impact of birth route on LOS was assessed using univariate analysis and multiple logistic regression.

Results:

A total of 8218 neonates were born via vaginal route and 11,820 via cesarean section. Incidence rates of LOS for infants born vaginally and via a cesarean section were 13.1 and 13.2%, respectively, and there was no significant difference in odds of LOS between the groups (adjusted odds ratio (AOR): 0.99; 95% CI 0.87 to 1.12); however, the odds of CONS sepsis were higher in the cesarean group (AOR: 1.15; 95% CI: 1.01 to 1.32).

Conclusion:

Birth route did not have an impact on LOS, but was associated with CONS-related LOS.

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Acknowledgements

Canadian Neonatal Network Site Investigators: Prakesh S Shah, MD, MSc (Director, Canadian Neonatal Network and Site investigator), Mount Sinai Hospital, Toronto, Ontario; Adele Harrison, MD, MBChB, Victoria General Hospital, Victoria, British Columbia; Anne Synnes, MDCM, MHSC, and Joseph Ting, MD, British Columbia Children’s Hospital, Vancouver, British Columbia; Zenon Cieslak, MD, Royal Columbian Hospital, New Westminster, British Columbia; Rebecca Sherlock, MD, Surrey Memorial Hospital, Surrey, British Columbia; Wendy Yee, MD, Foothills Medical Centre, Calgary, Alberta; Khalid Aziz, MBBS, MA, MEd, and Jennifer Toye, MD, Royal Alexandra Hospital, Edmonton, Alberta; Carlos Fajardo, MD, Alberta Children’s Hospital, Calgary, Alberta; Zarin Kalapesi, MD, Regina General Hospital, Regina, Saskatchewan; Koravangattu Sankaran, MD, MBBS, and Sibasis Daspal, MD, Royal University Hospital, Saskatoon, Saskatchewan; Mary Seshia, MBChB, Winnipeg Health Sciences Centre, Winnipeg, Manitoba; Ruben Alvaro, MD, St Boniface General Hospital, Winnipeg, Manitoba; Sandesh Shivananda, MBBS, MD, DM, Hamilton Health Sciences Centre, Hamilton, Ontario; Orlando Da Silva, MD, MSc, London Health Sciences Centre, London, Ontario; Chuks Nwaesei, MD, Windsor Regional Hospital, Windsor, Ontario; Kyong-Soon Lee, MD, MSc, Hospital for Sick Children, Toronto, Ontario; Michael Dunn, MD, Sunnybrook Health Sciences Centre, Toronto, Ontario; Brigitte Lemyre, MD, Children’s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, Ontario; Kimberly Dow, MD, Kingston General Hospital, Kingston, Ontario; Ermelinda Pelausa, MD, Jewish General Hospital, Montréal, Québec; Keith Barrington, MBChB, Hôpital Sainte-Justine, Montréal, Québec; Christine Drolet, MD, and Bruno Piedboeuf, MD, Centre Hospitalier Universitaire de Québec, Sainte Foy Québec; Martine Claveau, and Daniel Faucher, MD, McGill University Health Centre, Montréal, Québec; Valerie Bertelle, MD, and Edith Masse, MD, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec; Roderick Canning, MD, Moncton Hospital, Moncton, New Brunswick; Hala Makary, MD, Dr Everett Chalmers Hospital, Fredericton, New Brunswick; Cecil Ojah, MBBS, and Luis Monterrosa, MD, Saint John Regional Hospital, Saint John, New Brunswick; Akhil Deshpandey, MBBS, MRCPI, Janeway Children’s Health and Rehabilitation Centre, St John’s, Newfoundland; Jehier Afifi, MB BCh, MSc, IWK Health Centre, Halifax, Nova Scotia; Andrzej Kajetanowicz, MD, Cape Breton Regional Hospital, Sydney, Nova Scotia; Shoo K Lee, MBBS, PhD (Chairman, Canadian Neonatal Network), Mount Sinai Hospital, Toronto, Ontario.

Author information

Author notes

  1. F Olivier, V Bertelle, P S Shah, C Drolet and B Piedboeuf: A list of Canadian Neonatal Network Site Investigators is provided in the Acknowledgments section.

Authors and Affiliations

  1. Department of Pediatrics, Université Laval, CHU de Québec, Québec, Québec, Canada

    F Olivier, C Drolet & B Piedboeuf

  2. Department of Pediatrics, Université de Sherbrooke, Hôpital Fleurimont, Sherbrooke, Québec, Canada

    V Bertelle

  3. Department of Pediatrics, Mount Sinai Hospital, Maternal-Infant Care Research Centre, Toronto, Ontario, Canada

    P S Shah

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on behalf of the Canadian Neonatal Network Investigators

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Correspondence to F Olivier.

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The authors declare no conflicts of interest.

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Olivier, F., Bertelle, V., Shah, P. et al. Association between birth route and late-onset sepsis in very preterm neonates. J Perinatol 36, 1083–1087 (2016). https://doi.org/10.1038/jp.2016.146

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