Management of asymptomatic neonates born in the setting of chorioamnionitis: a safety comparison of the well-baby and intensive care setting

Background:evaluate the safety of a change in care setting for asymptomatic neonates born to mothers with chorioamnionitis from the neonatal intensive care unit to the well baby nursery.local problem:the neonatal intensive care unit evaluation and management of babies born to mothers with chorioamionitis often involves separation of the mother-baby dyad and more invasive interventions.methods:a single-center pre/post-intervention study of neonates born from january 2011 to november 2016, comparing safety outcomes in the neonatal intensive care unit (pre-intervention) and well baby nursery (post-intervention), following initiation of a triage protocol.interventions:a protocolized, systematic change was done in the practice location.results:groups were similar for time to first antibiotic administration, sepsis symptom development and positive blood cultures. length of stay (median 73.5 vs 64.4 h, p=0.0192) and % of neonates with intravenous fluid exposure (50.4% vs 7.6%, p<0.0001) were lower in the post-intervention group. exclusive breastfeeding rates improved (pre—7.3% vs post—46.1%, p<0.0001).conclusions:asymptomatic neonates born to mothers with chorioamnionitis were safely treated in a well baby nursery under the guidance of a protocol for triage, thereby reducing nicu exposure for these neonates.