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Vol. 88. Num. 5.01 May 2018Pages 237-290
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Vol. 88. Num. 5.01 May 2018Pages 237-290
Original Article
DOI: 10.1016/j.anpede.2017.05.008
Clinical observation of newborns with infection risk: A safe practice
Observación clínica de recién nacidos con factores de riesgo infeccioso, una práctica segura
Carla Escribano García
Corresponding author

Corresponding author.
, María del Mar Montejo Vicente, Raquel Izquierdo Caballero, Carmen María Samaniego Fernández, Sara Isabel Marín Urueña, María Elena Infante López, Sonia Caserío Carbonero
Servicio de Pediatría, Unidad Neonatología, Hospital Universitario Río Hortega, Valladolid, Spain
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Tables (3)
Table 1. Sample characteristics.
Table 2. Characteristics of the patients admitted to hospital that had a discharge diagnosis of sepsis.
Table 3. Characteristics of patients with a sepsis diagnosis that did not meet the inclusion criteria.
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Early-onset neonatal sepsis refers to an infection which starts during the first 72h of birth, and can lead to significant morbidity and mortality. Scientific evidence shows that infected infants present with symptoms during the first hours after delivery. There has been a significant decrease in this condition with the implementation of guidelines for its prevention. However, international guidelines still recommend the evaluation of these infants using painful tests.

Material and methods

A prospective cohort study was conducted on all asymptomatic infants born at >35 weeks gestation with one or more risk factors in a single tertiary care centre from 2011 to 2015. They were periodically observed in newborn nursery from admission until discharge looking for signs of infection.


Out of the 9,424 babies born during this period, 1,425 were included in the study. A total of 53 infants were admitted to the neonatal unit, half of them because of sepsis suspicion. Finally, just 7 were discharged with the diagnosis of sepsis. All these 7 presented with symptoms during their first 72h of life. No sepsis was reported in asymptomatic infants.


Truly infected infants present with symptoms during their first hours of life. This study supports the observation of infants at risk as a safe practice to detect early-onset sepsis.

Neonatal screening
Infant/newborn diseases
Early-onset sepsis

La sepsis vertical precoz es una causa importante de morbimortalidad neonatal. La evidencia científica apunta a que la mayoría de los recién nacidos infectados presentan síntomas en las primeras horas de vida. Tras la aplicación de las medidas para la prevención de sepsis vertical y el descenso en su incidencia, se han propuesto cambios en el manejo de estos niños. No obstante, la realización de exploraciones complementarias dolorosas aún sigue siendo una práctica muy extendida.

Material y métodos

Estudio prospectivo realizado entre 2011 y 2015. Se incluyó a todos los recién nacidos con edad gestacional ≥ 35 semanas, asintomáticos al nacimiento que presentaban uno o más factores de riesgo infeccioso. Durante su estancia en maternidad se realiza observación clínica periódica para la detección de síntomas compatibles con infección.


De los 9.424 recién nacidos en este periodo, 1.425 cumplían los criterios de inclusión del estudio; 53 pacientes precisaron ingreso, la mitad de ellos por sospecha de infección, confirmándose finalmente solo en 7 este diagnóstico. Todos los pacientes presentaron clínica en las primeras 72 h de vida.


Los niños con factores de riesgo infeccioso que desarrollan una infección presentan clínica de forma precoz en las primeras horas tras el nacimiento. Este trabajo apoya la observación clínica estrecha como medida suficiente y segura para la detección de la sepsis neonatal precoz.

Palabras clave:
Screening neonatal
Sepsis neonatal precoz
Infección neonatal


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