cliot (version 1.0.0)

neonatal_eos_calculator: Neonatal Early-Onset Sepsis (EOS) Calculator

Description

Calculates the probability of Early-Onset Sepsis (EOS) in newborns (>= 34 weeks gestation) based on maternal risk factors and the infant's clinical presentation. It uses a multivariate risk model (based on the Kaiser Permanente study) to adjust the prior probability derived from maternal factors by the likelihood ratio of the neonatal clinical status.

Usage

neonatal_eos_calculator(gestational_age_weeks, highest_maternal_temp_c,
                        rom_hours, gbs_status, intrapartum_antibiotics,
                        neonatal_appearance, baseline_incidence_per_1000 = 0.5)

Value

A list containing:

EOS_Risk_Per_1000

The calculated posterior probability of sepsis per 1000 births.

Clinical_Presentation

The input clinical status used for the likelihood ratio adjustment.

Recommendation

Management guidance based on the calculated risk and clinical status (Routine care, Enhanced observation, or Antibiotics).

Arguments

gestational_age_weeks

Numeric. Gestational age in weeks (must be >= 34).

highest_maternal_temp_c

Numeric. Highest maternal antepartum temperature in degrees Celsius.

rom_hours

Numeric. Duration of Rupture of Membranes in hours.

gbs_status

String. Maternal Group B Streptococcus status. Options: "positive", "negative", "unknown".

intrapartum_antibiotics

String. Type and duration of intrapartum antibiotics. Options: "none" (None or <2h before delivery), "specific_lt_2" (GBS Specific < 2h), "specific_2_to_3_9" (GBS Specific 2-3.9h), "specific_ge_4" (GBS Specific >= 4h), "broad_lt_2" (Broad Spectrum < 2h), "broad_2_to_3_9" (Broad Spectrum 2-3.9h), "broad_ge_4" (Broad Spectrum >= 4h).

neonatal_appearance

String. Clinical presentation of the neonate. "well_appearing": Normal exam. "equivocal": Abnormal vitals (e.g., tachycardia, tachypnea) but clinically stable. "clinical_illness": Severe respiratory distress, shock, need for mechanical ventilation/pressors.

baseline_incidence_per_1000

Numeric. The local baseline incidence of EOS per 1000 live births (default 0.5).

References

Puopolo KM, Draper D, Wi S, et al. Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors. Pediatrics. 2011;128(5):e1155-1163. Puopolo KM, et al. Management of Neonates Born at >=34 6/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics. 2018.

Examples

# Example 1: Well appearing, 40 weeks, GBS neg, PROM 18h, Temp 38.5C
neonatal_eos_calculator(40, 38.5, 18, "negative", "none", "well_appearing")

# Example 2: Equivocal exam, 36 weeks, GBS pos, No Abx
neonatal_eos_calculator(36, 37.0, 12, "positive", "none", "equivocal")