ABSTRACT
Intrapartum antibiotics are commonly given to women suspected of having chorioamnionitis.
However, there is no consensus regarding management of their babies. To date, there
are no data concerning the clinical courses and outcomes of term gestation, “pretreated”
neonates. We performed a retrospective review to assess the clinical courses of such
infants. From 1987 to 1989, chorioamnionitis was diagnosed in 123 women, 102 of whom
received intrapartum antibiotics. Of the 86 term gestation infants born to women in
the latter group, 63 were completely asymptomatic. When compared with these neonates,
the 23 symptomatic infants were more likely to have lower median 1 and 5 minute Apgar
scores (3 vs 8 and 7 vs 9, respectively; p <0.0001), higher immature: mature neutrophil
ratios on their initial complete blood counts (0.48 vs 0.24; p = 0.0003), and positive
urine antigen studies for group B Streptococcus in the presence of negative blood cultures (4 vs 2; p = 0.042). The intrapartum courses
of those infants destined to be symptomatic were more likely to be complicated by
fetal tachycardia (p = 0.049) and malodorous amniotic fluid (p = 0.005). Since more
than 95% of asymptomatic, pretreated, term gestation neonates have a benign clinical
course, aggressive evaluation and management of these infants may not be necessary.
