ArticlePediatrics2014
Stratification of risk of early-onset sepsis in newborns ≥ 34 weeks' gestation.
Article in Pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 144 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Trial in Intrapartum Fever Of No Antibiotics for Low-risk Women (RATIONAL)
Safely Reduce Newborn Antibiotic Exposure With the Early-onset Sepsis Calculator: a Cluster Randomized Study (EOS Calculator RCT)
Who cites it
144 citing papers in PubMed, 1 synthesis or guideline pooled it, 371 citations in OpenAlex.
- Management of neonates at risk of early onset sepsis: a probability-based approach and recent literature appraisal : Update of the Swiss national guideline of the Swiss Society of Neonatology and the Pediatric Infectious Disease Group Switzerland.European journal of pediatrics · 2024Guideline
- Association between intrapartum antibiotic prophylaxis for Group B Streptococcus colonization and clinical chorioamnionitis among patients undergoing induction of labor at term.American journal of obstetrics and gynecology · 2023Trial
- Effects of early-life antibiotics on the developing infant gut microbiome and resistome: a randomized trial.Nature communications · 2022Trial
- Antibiotic stewardship in the context of management of early onset neonatal sepsis-an evolving paradigm shift.World journal of clinical pediatrics · 2026Review
- Antibiotic Therapy for the Prevention and Treatment of Neonatal Sepsis.Clinics in perinatology · 2026Review
- Exploratory Hemodynamic and Hematologic Trajectories by Culture Status Among Neonates Evaluated for Infection.Children (Basel, Switzerland) · 2026Article
- A CBC drawn postnatally from umbilical cord blood can provide valuable diagnostic information for infants admitted to the NICU.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- A comparison between early onset sepsis (EOS) risk calculator and modified new protocol in a newborn ≥ 35 weeks: a simulation study.Italian journal of pediatrics · 2026Observational
- Duration of empiric antibiotic coverage for ruling out early-onset sepsis in neonates.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Comparing early-onset sepsis risk: risk calculator, American Academy of Pediatrics guidelines, and local care.Pediatric research · 2026Article
- Blood cultures to define neonatal early-onset sepsis: why not enough for clinical care?Pediatric research · 2026Article
- Real-world use of Serial Clinical Observation in culture-proven early-onset sepsis: timing of recognition, treatment and retrospective comparison with the Neonatal Sepsis Calculator.European journal of pediatrics · 2026Observational
- Inter-specialty differences in the management of febrile neonates on prostaglandin E1.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Mind the "CRP gender gap"! sex differences in CRP evolution over time in neonatal sepsis: a monocentric retrospective cohort study.Biology of sex differences · 2026Article
- Intrapartum recognition and management of fetal inflammation.European journal of pediatrics · 2026Review
- Antibiotic treatment for neonatal sepsis: changing trends and future directions.Drugs in context · 2026Review
- Hospital Admissions After Early-Onset Neonatal Bacterial Infection Management Guidelines in France.JAMA network open · 2025Article
- Clinical Outcomes of the Adapted AAP 2019 Guidelines on Early Onset Sepsis in Thailand.Antibiotics (Basel, Switzerland) · 2025Article
- Consequences of host-microbiome interactions in preterm infants.Infection and immunity · 2025Review
- Safety and effectiveness of the early-onset sepsis calculator to reduce antibiotic exposure in at-risk newborns: a cluster-randomised controlled trial.EClinicalMedicine · 2025Article
84 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveTo define a quantitative stratification algorithm for the risk of early-onset sepsis (EOS) in newborns ≥ 34 weeks' gestation.
methodsWe conducted a retrospective nested case-control study that used split validation. Data collected on each infant included sepsis risk at birth based on objective maternal factors, demographics, specific clinical milestones, and vital signs during the first 24 hours after birth. Using a combination of recursive partitioning and logistic regression, we developed a risk classification scheme for EOS on the derivation dataset. This scheme was then applied to the validation dataset.
resultsUsing a base population of 608,014 live births ≥ 34 weeks' gestation at 14 hospitals between 1993 and 2007, we identified all 350 EOS cases <72 hours of age and frequency matched them by hospital and year of birth to 1063 controls. Using maternal and neonatal data, we defined a risk stratification scheme that divided the neonatal population into 3 groups: treat empirically (4.1% of all live births, 60.8% of all EOS cases, sepsis incidence of 8.4/1000 live births), observe and evaluate (11.1% of births, 23.4% of cases, 1.2/1000), and continued observation (84.8% of births, 15.7% of cases, incidence 0.11/1000).
conclusionsIt is possible to combine objective maternal data with evolving objective neonatal clinical findings to define more efficient strategies for the evaluation and treatment of EOS in term and late preterm infants. Judicious application of our scheme could result in decreased antibiotic treatment in 80,000 to 240,000 US newborns each year.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.