Heart rate and oxygen saturation patterns in very low birth weight infants with early onset sepsis and histologic chorioamnionitis

Abstract

BACKGROUND:

Chorioamnionitis and early onset sepsis (EOS) in very low birth weight (VLBW,< 1500 g) infants may cause a systemic inflammatory response reflected in patterns of heart rate (HR) and oxygenation measured by pulse oximetry (SpO₂). Identification of these patterns might inform decisions about duration of antibiotic therapy after birth.

OBJECTIVE:

Compare early HR and SpO₂ patterns in VLBW infants with or without early onset sepsis (EOS) or histologic chorioamnionitis (HC).

STUDY DESIGN:

Retrospective study of placental pathology and HR and SpO₂ in the first 72 h from birth in relation to EOS status for inborn VLBW NICU patients 2012–2019.

RESULT:

Among 362 VLBW infants with HR and SpO₂ data available, clinical, or culture-positive EOS occurred in 91/362 (25%) and HC in 81/355 (22%). In univariate analysis, EOS was associated with higher mean HR, lower mean SpO₂, and less negative skewness of HR in the first 3 days after birth. HC was associated with higher standard deviation and skewness of HR but no difference in SpO₂. In multivariable modeling, significant risk factors for EOS were mean HR, gestational age, HC, mean SpO₂, and skewness of SpO₂.

CONCLUSION:

HR and SpO₂ patterns differ shortly after birth in VLBW infants exposed to HC or with EOS, likely reflecting a systemic inflammatory response.