{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T13:37:48Z","timestamp":1793972268373,"version":"4.8.0"},"reference-count":43,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wei Gong Memorial Hospital","award":["WMH-113-005"],"award-info":[{"award-number":["WMH-113-005"]}]},{"name":"Wei Gong Memorial Hospital","award":["DMR-106-042"],"award-info":[{"award-number":["DMR-106-042"]}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["WMH-113-005"],"award-info":[{"award-number":["WMH-113-005"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-106-042"],"award-info":[{"award-number":["DMR-106-042"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>The global evolution of pathogens causing early-onset sepsis (EOS), a critical condition in preterm infants, necessitates a re-evaluation of risk factors to develop updated prevention and treatment strategies. This nationwide case\u2013control study in Taiwan analyzed data from the National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database from 2010 to 2019. The study included 176,681 mother\u2013child pairs with preterm births. We identified 2942 clinical EOS cases from 5535 diagnosed sepsis cases, excluding unlikely cases. A control group of 14,710 preterm neonates without EOS was selected at a 1:5 ratio. Clinical EOS increased since 2017. Adjusted logistic regression identified significant EOS risk factors in preterm infants, including maternal fever, chorioamnionitis, maternal diabetes mellitus, maternal antibiotic usage, very preterm birth, birth weight (all with p &lt; 0.001), maternal pneumonia (p = 0.002), and maternal CS (p = 0.004). Effective treatment of maternal conditions like diabetes, fever, and infections is essential to prevent EOS in preterm infants. Key measures include reducing unnecessary antibiotics or steroids, minimizing unnecessary cesarean sections, avoiding premature or prolonged rupture of membranes (PPROM), and increasing gestational age and neonatal birth weight. High-risk preterm neonates should be closely monitored for EOS and considered for antibiotics when warranted.<\/jats:p>","DOI":"10.3390\/pathogens14010089","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T08:46:26Z","timestamp":1737449186000},"page":"89","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Maternal Infections, Antibiotics, Steroid Use, and Diabetes Mellitus Increase Risk of Early-Onset Sepsis in Preterm Neonates: A Nationwide Population-Based Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7401-856X","authenticated-orcid":false,"given":"Hao-Yuan","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, No. 79-9, Sha-Luen-Hu, Xi-Zhou Li, Hou-Loung Town, Miaoli 35664, Taiwan"},{"name":"Department of Pediatrics, Wei Gong Memorial Hospital, Miaoli 35159, Taiwan"},{"name":"School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 242062, Taiwan"},{"name":"Division of Pediatric Infectious Diseases, China Medical University Children\u2019s Hospital, China Medical University, Taichung 40447, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3010-2767","authenticated-orcid":false,"given":"Yu-Lung","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, China Medical University Children\u2019s Hospital, China Medical University, Taichung 40447, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Yuan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wei Gong Memorial Hospital, Miaoli 35159, Taiwan"},{"name":"Department of Neurosurgery, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-6202","authenticated-orcid":false,"given":"Kuang-Hua","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Health Services Administration, China Medical University, Taichung 40447, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3727-7033","authenticated-orcid":false,"given":"Ming-Luen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Neonatology, China Medical University Children\u2019s Hospital, China Medical University, Taichung 40447, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chyi-Liang","family":"Chen","sequence":"additional","affiliation":[{"name":"Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333423, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7347-0615","authenticated-orcid":false,"given":"Yu-Chia","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Long Term Care, College of Health and Nursing, National Quemoy University, No. 1, University Road, Jinning Township, Kinmen County 892009, Taiwan"},{"name":"Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Chih","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Neonatology, China Medical University Children\u2019s Hospital, China Medical University, Taichung 40447, Taiwan"},{"name":"Department of Pediatrics, Asia University Hospital, Asia University, Taichung 41300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.pedneo.2021.02.005","article-title":"An 18-year retrospective study on the epidemiology of early-onset neonatal sepsis\u2014Emergence of uncommon pathogens","volume":"62","author":"Ko","year":"2021","journal-title":"Pediatr. 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