Neonatal infections are relatively common and may occur through multiple transmission routes, including transplacental spread, intra-amniotic infection, or exposure during delivery. These infections can have serious consequences for the newborn if not promptly recognized and managed.
What causes neonatal infections?
Neonates may acquire infections through several pathways:
- Transplacental (hematogenous) transmission: Occurs before birth via maternal bloodstream. Common pathogens include congenital syphilis, HIV, rubella virus, cytomegalovirus (CMV), and Toxoplasma gondii.
- Ascending infection via amniotic fluid: Associated with maternal genitourinary infections, cervical incompetence, premature rupture of membranes (PROM), or frequent vaginal examinations during pregnancy.
- Peripartum exposure during delivery: Occurs when the newborn passes through the birth canal, particularly in cases of prolonged labor, increasing the risk of exposure to maternal pathogens.
- Postnatal environmental exposure: May lead to neonatal sepsis through contaminated medical equipment (e.g., needles, catheters, gastric tubes), inadequate hand hygiene, or unclean environments. The risk is higher in preterm infants, low birth weight neonates, those requiring resuscitation at birth, or prolonged hospitalization.
How to recognize neonatal infections
Clinical manifestations of neonatal infections are often nonspecific and may overlap with other conditions. Common signs include:
- Lethargy, decreased activity, or poor responsiveness
- Fever or hypothermia
- Jaundice
- Poor feeding or refusal to feed
- Respiratory distress (tachypnea, chest retractions)
- Abdominal distension, diarrhea, or blood-stained stools
- Localized infections involving the skin, umbilicus, or eyes
When should medical evaluation be sought?
Immediate medical attention is required if the newborn presents with:
- Respiratory distress
- Seizures
- Fever or hypothermia
- Bleeding or severe diarrhea
- Inability to feed
- Marked low birth weight
Parents should seek prompt medical evaluation if the infant shows:
- Poor feeding or feeding difficulty
- Purulent eye discharge
- Skin pustules
- Jaundice
- Redness or discharge from the umbilical stump
- Feeding fewer than five times within 24 hours
Prevention of neonatal infections
Antenatal care
- Regular prenatal check-ups and complete maternal immunization
- Early detection and treatment of maternal infections, particularly genitourinary infections
- Adequate nutritional supplementation to prevent maternal malnutrition
- Maintenance of proper hygiene during pregnancy
- Appropriate management of premature or prolonged rupture of membranes and prevention of prolonged labor
Intrapartum care
- Ensuring aseptic delivery practices
- Preventing infection transmission via instruments or healthcare personnel
- Proper management of maternal infections during labor
- Avoiding obstetric complications such as birth asphyxia and birth trauma
Postnatal care
- Strict hand hygiene before and after neonatal care
- Proper hygiene of the skin, umbilical stump, and eyes
- Maintaining a clean, warm, and well-ventilated environment
- Encouraging exclusive breastfeeding
Disclaimer: The information provided by Hong Ngoc General Hospital is for reference purposes only and does not replace professional medical diagnosis or treatment. For an accurate diagnosis and appropriate management, patients should seek direct evaluation by qualified healthcare professionals.
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