Risk of death from post-birth infection in newborns

The article was consulted professionally by Dr. Nguyen Thi My Linh – Department of Pediatrics – Newborn – Share99 Da Nang International Health Hub. He has 12 years of experience in diagnosing and treating pediatric diseases, especially newborn resuscitation and newborn treatment. In addition, doctors have strengths in the field of breastfeeding counseling as well as examination, counseling and nutritional intervention in children.

Babies have not developed enough immune system to fight the pathogens, so babies can have post-birth infections due to different causes, post-birth infections if not detected and treated early can seriously affect the health of babies , increasing the risk of post-birth death.

Newborn infections are infections that occur from birth to 28 days of age. Newborn infections can be caused by pre-birth, during birth and after birth. Newborn infections have the second highest mortality rate after respiratory distress syndrome in newborns.

Babies may become infected after birth through the following paths:

• Placenta (blood): Is the transmission line that occurs before birth, often encountering such causes as congenital syphilis, HIV, rubella, cytomegalovirus, toxoplasmosis
• Transmission through membranes and amniotic fluid
• Transmission of contact at birth: During pregnancy through the vagina, vagina or intra-uterus infections
• After birth may be due to exposure to infectious diseases in the community especially in hospital environments

3.1 Med risk factors

• Mother contracted infection during pregnancy (rubella, toxoplasmosis, cytomegalovirus …).
• Early amniotic rupture before 12 hours causes an amniotic infection.
• Mother fever before, during and after birth.
• Labor lasts more than 12 hours, especially over 18 hours.
• The mother has a pre-birth urinary tract infection without proper treatment or without treatment.

3.2 Child risk factors

• Boy.
• Premature babies.
• Slightly weight compared to gestational age.
• Obstetric trauma.
• Apgar index is low at birth (normally Apgar 8 – 10đ in the first minutes).

3.3 Environmental risk factors

• Direct or indirect transmission through the child's mother, family, health officials
• Non-aseptic medical instruments
• Intrusive procedures (catheter, intt management…)
• Do not wash your hands before contacting your baby.
• Through breast milk, excreted substances

The signs of post-birth infection in babies are varied, which can be divided into 2 stages: early newborn infection and late newborn infection.

4.1 Early newborn infections

Early newborn infection is an infection that occurs within the first 72 hours after birth.

Clinical symptoms of early newborn infection may include:

• Respiration: Blue-violet, arrhythmias, moaning, rapid breathing > 60 times /min + convulsions, > 15 seconds.
• Cardiovascular: Blue, skin floating, tachycardia > 160 times / minute, cold head and genus, pink time back of the skin lasts > 3s, blood pressure lowers.
• Digestion: Poor feeding, breastfeeding, abdominal distension, vomiting, diarrhea, gastric fluid > 2/3 of the amount of pumped milk first.
• Skin and mucous membranes: Recurrent skin, violet rash, rash, hemorrhage, jaundice early before 24 hours. pus nodules, edema, hardening of the scrotal.
• Nerves: Increased or decreased muscle muscle muscle, prone to irritation, convulsions, puffiness, decreased reflexes, coma.
• Hematological: Zimorrhosis, hypopundice hematoma, multiple hemorrhages, enlarged liver.

4.2 Late newborn infections

Late newborn infection is an infection that occurs after 72 hours after birth. The main clinical forms are sepsis, meningitis, local infections

Clinical symptoms of late newborn infection:

• Sepsis: Symptoms are similar to early newborn infections.
• Meningitis: Possible individual symptoms, inaction, persistent fever or unstable body temperature, altered sense, changes in muscle movement, convulsions, prone to irritation, apnea, crying, bulging, meningeal symptoms may or may not be, breathing is uneven, vascular disorders, vomiting.
• Skin infections can take the following forms:
• Pus nodules with the head of the pin, evenly at the beginning in the back of the pus. Dry acne leaves white scales easy to peel off.
• The nodules are unevenly large, at first containing internal fluid if infected, there is turbid pus, rupture leaving a red background, the internal fluid spreads around the new acne.
• Flaking dermatitis (Ritter's disease): At first pustules around the mouth after the whole body spread, the epidermis cracked in patches, leaving a wet redness of the plasma. Signs of high fever, dehydration, may be accompanied by pneumonia, diarrhea, septicaemia.
• Umbilical infections: Wet navel, red swelling, bruising, purulent discharge or blood, odor, swelling of the pulse, possible fever, poor appetite, abdominal distension, digestive disorders.
• Urinary infections: Often there is jaundice.
• Necrotizing enteritis: Go outside the blood stools, abdominal obstruction, vomiting.
• Mucosal infections include:
• Conjunctivitis: The child closes his eyes, redness of the eyelids, discharge or purulent discharge.
• Oral fungus: The fungus is usually on the upper side of the tongue, at first white like milk residue, the fungus grows thicker, spreads throughout the tongue, the inside of the cheeks down the throat, yellowish fungus hurts the child to breastfeed. Can cause diarrhea, pneumonia if the fungus falls into the gastrointestinal tract and lungs.

Uns treated newborn infections can lead to serious consequences such as:

• Affects children's growth and development in nerves, senses, agencies such as cardiovascular, respiratory …
• In some cases severe post-birth infections can lead to death. Due to the weak immune system of young children, they are not sufficiently capable of responding to infection.

Infection in babies is classified as a highly dangerous and fatal disease. When detecting signs of suspected post-birth infection, the child should be taken to a medical facility for examination and treatment. Early diagnosis, quick treatment and care, regular monitoring is the best way to treat the child.

As a key area of Share99 Health System, Pediatrics always brings satisfaction to customers and is highly appreciated by industry experts with:

• Gathering a team of leading doctors in Pediatrics:including leading experts, highly specialized (professors, associate professors, doctors, masters), experienced, used to work at large hospitals such as Bach Mai, 108.. The doctors are well-trained, professional, mind-centered, knowledgeable about the child's psychology. In addition to domestic pediatricians, pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) always pioneering the application of the latest and most effective treatment regimens.
• Comprehensive services:In the field of Pediatrics, Share99 provides a chain of continuous medical examination and treatment services from Newborn to Pediatrics and Vaccines,… according to international standards to take care of your baby's health with parents from birth to adulthood
• Intensive techniques:Share99 has successfully implemented many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery – skull, hematoma stem cell transplantation in cancer treatment.
• Professional care:In addition to understanding the young psychology, Share99 also pay special attention to the children's play space, help them play comfortably and get acquainted with the hospital environment, cooperate in treatment, improve the efficiency of medical examination and treatment.