1. Diagnosis of congenital/perinatal infections by neonatologists: a national survey.
- Author
-
Hwang JS, Friedlander S, Rehan VK, and Zangwill KM
- Subjects
- Clinical Decision-Making, Cytomegalovirus Infections diagnosis, Female, Herpes Simplex diagnosis, Humans, Infant, Newborn, Logistic Models, Multivariate Analysis, Practice Patterns, Physicians', Pregnancy, Rubella diagnosis, Surveys and Questionnaires, Syphilis diagnosis, Toxoplasmosis, Congenital diagnosis, United States, Fetal Diseases diagnosis, Infant, Newborn, Diseases diagnosis, Neonatologists statistics & numerical data
- Abstract
Objective: To describe the clinical approach used by neonatologists for diagnosis of congenital/perinatal infections (CPI); no such data currently exist., Study Design: A national survey regarding the diagnosis of toxoplasma, syphilis, rubella, cytomegalovirus, and herpes simplex virus (HSV) infection in neonates., Result: We received 553 (11%) responses. Central nervous system calcification or hydrocephalus was the commonest trigger to pursue a CPI diagnosis (98%); maternal history was the least frequent (67%). Four hundred twenty-two (76%) used general screening such as "TORCH titer screen" (57%) or total IgG or IgM (39%). Further evaluation targeted known clinical sequelae; but cerebrospinal fluid testing was used in only 65% of those suspected of having HSV or syphilis. Fifty-six percent chose a treponemal instead of a non-treponemal test for syphilis. Multivariable analyses did not identify factors associated with the clinical diagnostic approach., Conclusion: We observed clinically important deviations from CPI diagnostic test recommendations in a national cohort of neonatologists.
- Published
- 2019
- Full Text
- View/download PDF