ArticlePediatrics2017
Identification of Extremely Premature Infants at Low Risk for Early-Onset Sepsis.
Article in Pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 2 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
60 citing papers in PubMed, 2 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- Presepsin for the Diagnosis of Neonatal Early-Onset Sepsis: A Systematic Review and Meta-analysis.JAMA pediatrics · 2022Pooled it
- Association of Histological and Clinical Chorioamnionitis With Neonatal Sepsis Among Preterm Infants: A Systematic Review, Meta-Analysis, and Meta-Regression.Frontiers in immunology · 2020Pooled it
- Trial
- Early-Onset Sepsis in Preterm Neonates of 22-28 Weeks' Gestation: An International Cohort Study.Journal of pediatrics. Clinical practice · 2026Article
- Maternal and infant gut microbiome.iMeta · 2026Review
- Long-term sustainability and safety of a delivery-based early-onset sepsis evaluation strategy for very low birth weight infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Blood cultures to define neonatal early-onset sepsis: why not enough for clinical care?Pediatric research · 2026Article
- Maternal and neonatal determinants of newborn sepsis: A case-control study in resource-limited settings.World journal of clinical pediatrics · 2026Article
- Predictors, aetiology and outcome of early-onset neonatal bloodstream infection: a case-control study in a tertiary hospital in South Africa.Journal of tropical pediatrics · 2026Article
- Duration of early empirical antibiotic exposure in very low birth weight infants with suspected early-onset sepsis and associated factors: a retrospective cohort study.Frontiers in pediatrics · 2026Article
- Prevalence and risk factors for neonatal sepsis among very preterm infants in China: a systematic review and meta-analysis.Frontiers in pediatrics · 2026Review
- Identifying Infants <32 Weeks' Gestation at Low Risk of Early-Onset Sepsis: A 10-Year Retrospective Study from Western Australia.Neonatology · 2026Article
- Antibiotic exposure and infection epidemiology among newborns with congenital diaphragmatic hernia.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- The double-edged sword of early antibiotic exposure in extremely preterm infants: implications for necrotizing enterocolitis and growth faltering.Pediatric research · 2025Article
- Antibiotic use among extremely low birth-weight infants from 2009 to 2021: a retrospective observational study.Archives of disease in childhood. Fetal and neonatal edition · 2025Observational
- Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study.Pathogens (Basel, Switzerland) · 2025Article
- Use and utility of C-reactive protein (CRP) in neonatal early-onset sepsis: a secondary analysis of a prospective surveillance study.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- Exploring factors influencing delayed first antibiotic treatment for suspected early-onset sepsis in preterm newborns: a study before quality improvement initiative.BMC pediatrics · 2024Article
- Early Antibiotic Exposure and Bronchopulmonary Dysplasia in Very Preterm Infants at Low Risk of Early-Onset Sepsis.JAMA network open · 2024Article
- [Advances in clinical management of neonatal sepsis].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Review
Corrections and comments
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Authors and funding
12 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundPremature infants are at high risk of early-onset sepsis (EOS) relative to term infants, and most are administered empirical antibiotics after birth. We aimed to determine if factors evident at birth could be used to identify premature infants at lower risk of EOS.
methodsStudy infants were born at 22 to 28 weeks' gestation in Neonatal Research Network centers from 2006 to 2014. EOS was defined by isolation of pathogenic species from blood or cerebrospinal fluid culture at ≤72 hours age. Infants were hypothesized as "low risk" for EOS when delivered via cesarean delivery, with membrane rupture at delivery, and absence of clinical chorioamnionitis. Frequency of prolonged antibiotics (≥5 days) was compared between low-risk infants and all others. Risks of mortality, EOS, and other morbidities were assessed by using regression models adjusted for center, race, antenatal steroid use, multiple birth, sex, gestation, and birth weight.
resultsOf 15 433 infants, 5759 (37%) met low-risk criteria. EOS incidence among infants surviving >12 hours was 29 out of 5640 (0.5%) in the low-risk group versus 209 out of 8422 (2.5%) in the comparison group (adjusted relative risk = 0.24 [95% confidence interval, 0.16-0.36]). Low-risk infants also had significantly lower combined risk of EOS or death ≤12 hours. Prolonged antibiotics were administered to 34% of low-risk infants versus 47% of comparison infants without EOS.
conclusionsDelivery characteristics of extremely preterm infants can be used to identify those with significantly lower incidence of EOS. Recognition of differential risk may help guide decisions to limit early antibiotic use among approximately one-third of these infants.
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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.