TABLE 1

Approach to EOS Risk Assessment

Pre-SRC Implementation
Clinical Risk FactorRecommendations
Clinical illnessBlood culture at birth
Obstetric diagnosis of chorioamnionitisCBC count and differential; CRP level at birth, at 12 h of age, and 24 h of age
Administer empirical antibiotics
Inadequate indicated GBS IAP and GA ≤36 wk or ROM ≥18 hBlood culture at birth
CBC count and differential and CRP level at 12 h of age
Inadequate indicated GBS IAP and no additional risk factorsCBC count and differential, CRP level at 12 h of age
Adequate indicated GBS IAP and GA ≤36 wk
Maternal temperature ≥100.4°F (not chorioamnionitis)
 ROM ≥18 h
Post-SRC Implementation
 SRC <0.70Routine WBN vital signsa
 SRC 0.70–1.49 Vital signs every 4 h until 36 h of age
 SRC ≥1.5 Admission to NICU
 Blood culture at birth
 Empirical antibiotics for 48 h
  • GA, gestational age; IAP, intrapartum antibiotic prophylaxis.

  • a Routine WBN newborn care during both study periods included vital signs every hour for 3 h after transfer to the WBN followed by vital signs every 4 h until 12 h of age and every 12 h thereafter. In both study periods, infants for whom antibiotics were initiated could be transferred to the WBN if they were well appearing after the first antibiotic doses were administered.