(60) Maternal Fever and PPROM Are Associated with Early Neonatal Illness Severity: A Composite Score Analysis in NICU Admissions

Background: Maternal complications during delivery may predispose neonates to early clinical instability. Identifying specific maternal risk factors can help stratify neonatal risk and guide early postnatal care.

Objectives: To assess the relationship between maternal complications and early neonatal illness severity using a composite clinical illness score.

Design/Methods: This retrospective cohort study included neonates admitted to a level IV NICU. Maternal factors analyzed included chorioamnionitis, fever, PPROM, preeclampsia, and intrapartum antibiotic exposure. Neonatal illness severity was defined using a 5-point composite score incorporating hypotension, need for hydrocortisone, elevated CRP, presence of multiple central lines, and ≥5 days of central line use. Linear regression models were used to assess associations between maternal factors and illness score, adjusting for gestational age and birthweight.

Results: Among the maternal factors analyzed, maternal fever (p = 0.021) and PPROM (p = 0.038) were independently associated with higher neonatal illness scores. Chorioamnionitis and preeclampsia were not significantly associated after adjustment.

Conclusions: Maternal fever and PPROM are independently associated with increased early neonatal illness severity, even after accounting for gestational age and birthweight. These findings support targeted surveillance and management strategies for neonates exposed to these maternal complications.