risk factors for and clinical indicators of possible early-onset neonatal infection

Suspected or confirmed infection in another baby in the case of a multiple pregnancy.

Invasive group B streptococcal infection in a previous baby or maternal group B streptococcal colonisation, bacteriuria or infection in the current pregnancy.

Pre-term birth following spontaneous labour before 37 weeks' gestation.

Confirmed rupture of membranes for more than 18 hours before a pre-term birth.

Confirmed prelabour rupture of membranes at term for more than 24 hours before the onset of labour.

Intrapartum fever higher than 38°C if there is suspected or confirmed bacterial infection.

Clinical diagnosis of chorioamnionitis.

Apnoea (temporary stopping of breathing)

Seizures

Need for cardiopulmonary resuscitation

Need for mechanical ventilation

Signs of shock

Altered behaviour or responsiveness

Altered muscle tone (for example, floppiness)

Feeding difficulties (for example, feed refusal)

Feed intolerance, including vomiting, excessive gastric aspirates and abdominal distension

Abnormal heart rate (bradycardia or tachycardia)

Signs of respiratory distress (including grunting, recession, tachypnoea)

Hypoxia (for example, central cyanosis or reduced oxygen saturation level)

Persistent pulmonary hypertension of newborns

Jaundice within 24 hours of birth

Signs of neonatal encephalopathy

Temperature abnormality (lower than 36°C or higher than 38°C) unexplained by environmental factors

Unexplained excessive bleeding, thrombocytopenia, or abnormal coagulation

Altered glucose homeostasis (hypoglycaemia or hyperglycaemia)

Metabolic acidosis (base deficit of 10 mmol/litre or greater)