Septicaemia of the newborn, associated with ruptured foetal membranes, discoloured amniotic fluid or maternal fever.

The incidence of neonatal septicaemia associated with prolonged rupture of foetal membranes, discoloured amniotic fluid and/or maternal fever was investigated. A total of 807 blood cultures were performed on 329 neonates, the placental end of 239 umbilical cords and on 239 mothers. The study showed that in 97% of the neonates with a complicated delivery there was no evidence of septicaemia. Septicaemia was verified in 3% of the infants, and was intimately associated with low birth weight (p equals 0.02), neonatal asphyxia (p less than 10(-4)), clinical evidence of septicaemia (p less than 10(-4) and maternal fever (p equals 0.002). The incidence was particularly high in premature infants with neonatal asphyxia (27%) and in neonates born to febrile mothers (20%). None of the mothers showed any evidence of septicaemia, and haematogenous, transplacental spread of infection to the child was not seen. Routine prophylactic antibiotic therapy in neonates with a complicated delivery should therefore be reserved, in our opinion, for those infants at high risk of infection.