427 - The Impact of Chorioamnionitis and Early Onset Sepsis on Heart Rate and SpO2 in Very Low Birth Weight Infants

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 427
Publication Number: 427.335

Charlene R. Bultmann, University of Virginia School of Medicine, Charlottesville, VA, United States; Jiaxing Qiu, University of Virginia School of Medicine, CHARLOTTESVILLE, VA, United States; Karen Fairchild, University of Virginia School of Medicine, Charlottesville, VA, United States; Brynne Sullivan, University of Virginia, Charlottesville, VA, United States

Presenting Author(s)

Charlene R. Bultmann, DO (she/her/hers)

Neonatal-Perinatal Medicine Fellow
University of Virginia School of Medicine
Charlottesville, Virginia, United States

Background: Chorioamnionitis and early onset sepsis (EOS) in very low birth weight (VLBW) infants may cause a systemic inflammatory response reflected in patterns of heart rate (HR) and oxygenation measured by pulse oximetry (SpO₂).

Objective: Determine whether early HR and SpO₂ data contain patterns associated with chorioamnionitis and blood culture-positive EOS or clinical sepsis, versus ruled-out EOS, or no suspected EOS.

Design/Methods:

We conducted a retrospective study of all inborn VLBW infants admitted to the University of Virginia NICU from 2012-2019 with at least 4 hours of every-2-second HR and SpO₂data available in the first 24h after birth. Hourly HR and SpO₂mean, standard deviation, skewness and kurtosis were calculated for each infant and group means were compared based on histologic chorioamnionitis and EOS category.

Results: 397 infants had at least 4h of HR and SpO₂ data available (Figure 1). The mean GA for each of the 4 groups ranged between 26.3 and 30.5 weeks. Histologic chorioamnionitis was present in 21%. In the 72 hours after birth, mean HR was higher in infants with EOS or clinical sepsis compared to those with sepsis ruled out or no culture obtained (Figure 2). HR was higher in infants of mothers with histologic chorioamnionitis (Figure 3). In addition to higher HR, infants with EOS had lower mean SpO₂.

Conclusion(s): HR is higher and SpO₂lower in VLBW infants with culture-proven or clinical EOS and histologic chorioamnionitis. Future work will adjust for clinical variables and determine whether HR and SpO₂analysis can reduce antibiotic exposure after birth for VLBW infants.