Academic Journal
Maternal-Fetal Infectious Risk and Early Antibiotic Treatment Patterns in Late Preterm and Term Newborns in a Romanian Secondary-Care Maternity: A Six-Month Observational Cohort.
| Τίτλος: | Maternal-Fetal Infectious Risk and Early Antibiotic Treatment Patterns in Late Preterm and Term Newborns in a Romanian Secondary-Care Maternity: A Six-Month Observational Cohort. |
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| Συγγραφείς: | Vulcănescu A; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Bica CE; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Pediatrics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Siminel MA; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Neonatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Dinescu SN; Department of Epidemiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.; Clinical Emergency County Hospital, 200642 Craiova, Romania., Manolea MM; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Săndulescu SM; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Rădulescu VM; Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Gheorman V; Department of Obstetrics and Gynecology, Buna Vestire Clinic, 200345 Craiova, Romania., Dijmărescu AL; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania. |
| Πηγή: | Biomedicines [Biomedicines] 2026 Feb 27; Vol. 14 (3). Date of Electronic Publication: 2026 Feb 27. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101691304 Publication Model: Electronic Cited Medium: Print ISSN: 2227-9059 (Print) Linking ISSN: 22279059 NLM ISO Abbreviation: Biomedicines Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Basel, Switzerland : MDPI AG, [2013]- |
| Περίληψη: | Background: Microbiological confirmation of early-onset neonatal infection is inconsistently available in many secondary-care maternity units, and early management often relies on maternal risk profiles and inflammatory markers. Objectives: This study aimed to describe maternal infectious risk factors, neonatal biomarkers, and early antibiotic treatment patterns among late preterm and term newborns evaluated for suspected maternal-fetal infection (MFI) in a Romanian secondary-care maternity, and to explore whether a simplified bedside indicator (NeoSIR) corresponded with antibiotic initiation and treatment-related outcomes. Methods: Observational cohort study (April-September 2024) including newborns with gestational age ≥ 35 weeks evaluated within 24 h for suspected MFI based on maternal risk factors and/or neonatal clinical findings. We recorded maternal infections and screening results, neonatal complete blood count and C-reactive protein (CRP) at 24 h, cultures obtained as part of routine care, antibiotic initiation, treatment duration, and neonatal intensive care unit (NICU) admission. Results: Among 443 newborns, empirical antibiotics were initiated in 414 (93.5%) and 62 (14.0%) required NICU admission. Maternal urinary tract infection (UTI) documented during pregnancy (recorded diagnosis and/or positive urine culture and/or treatment) was associated with antibiotic initiation (p = 0.005). Elevated CRP (>0.5 mg/dL) was associated with antibiotic selection (p = 0.032) and longer therapy (mean 8.33 vs. 6.98 days, p < 0.001); courses were also longer in NICU-admitted infants (mean 10.39 vs. 6.81 days, p < 0.001). The exploratory two-item NeoSIR indicator (maternal UTI and CRP > 0.5 mg/dL) was feasible to compute but showed limited discrimination for antibiotic initiation in this high-treatment cohort. Conclusions: In this selected high-risk cohort, antibiotic exposure was highly prevalent and closely associated with maternal urinary tract infection history and neonatal CRP evolution. These findings primarily describe early management patterns in a secondary-care maternity with limited microbiological confirmation and should be interpreted as hypothesis-generating. The exploratory NeoSIR indicator is not intended as a diagnostic or decision-support tool and requires validation against culture-confirmed outcomes in more heterogeneous populations. |
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| Contributed Indexing: | Keywords: Romania; antibiotic stewardship; early-onset neonatal infection; maternal risk factors; neonatal biomarkers; suspected maternal–fetal infection |
| Entry Date(s): | Date Created: 20260328 Date Completed: 20260328 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13024130 |
| DOI: | 10.3390/biomedicines14030538 |
| PMID: | 41898185 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2227-9059 |
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| DOI: | 10.3390/biomedicines14030538 |