Generality/Definition
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By definition, neonatal conjunctivitis presents during the first month of life and may be aseptic or septic. Aseptic neonatal conjunctivitis most often is a chemical conjunctivitis that is induced by silver nitrate solution, which is used for prophylaxis of infectious conjunctivitis. Bacterial, chlamydial, and viral infections are major causes of septic neonatal conjunctivitis, chlamydia being the most common infectious agent. Infants may acquire these infective agents as they pass through the birth canal during the birth process.
Source: Conjunctivitis, Neonatal (emedicine.com)
Other information:
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When conjunctivitis occurs in babies younger than 4 weeks old, it is called neonatal conjunctivitis or ophthalmia neonatorum. Newborns are also susceptible to infectious conjunctivitis, which can be serious. The sexually transmitted bacteria Chlamydia trachomatis and Neisseria gonorrhoeae can pass from an infected mother's birth canal into her baby's eyes during delivery. These bacteria can cause symptoms of conjunctivitis in babies within the first 2 weeks of life, and both can lead to serious eye damage. Less commonly, the viruses that cause genital and oral herpes can similarly be passed to an infant at the time of delivery and may also damage the eyes.
Source: Pinkeye (Conjunctivitis) (kidshealth.org)
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Epidemiology
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- In the US: The incidence of infectious neonatal conjunctivitis ranges from 1-2%, depending on the socioeconomic character of the area. The epidemiology of neonatal conjunctivitis has changed since silver nitrate solution was introduced to prevent gonococcal ophthalmia. Chlamydia has been reported as the most common infectious agent that causes ophthalmia neonatorum in the US (incidence is 6.2 per 1000 live births). In contrast, the incidence of gonococcal ophthalmia neonatorum has been reduced dramatically, from 100 per 1000 live births to 3 per 1000 live births.
- Internationally: As in the US, incidence of ophthalmia neonatorum in many other countries also decreased after silver nitrate solution was used. In Europe, incidence fell from 10% of births to less than 1%. The incidence was less than 7 per 1000 live births in 1943 in England. A higher incidence of ophthalmia neonatorum exists in developing countries.
- In a Nairobi hospital, the incidences of gonococcal and chlamydial conjunctivitis were 40 per 1000 and 80 per 1000 (per live newborn), respectively. More than 50% of newborns in Nairobi had concurrent gonococcal conjunctivitis. Prophylaxis was not administered at birth in this area.
- The prevalence of gonorrhea also was high among antenatal attenders in African countries, ranging from 4-15%.
Source: Conjunctivitis, Neonatal (emedicine.com)
Prevention
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Many cases of neonatal conjunctivitis are prevented by screening and treating pregnant women for sexually transmitted diseases. The mother-to-be may have bacteria in her birth canal even if she shows no symptoms, which is why prenatal screening is important. Other cases are prevented by treating all newborns with antibiotic ointment or eyedrops in the delivery room. This practice in certain countries, including the United States, has significantly decreased the rate of conjunctivitis due to gonorrhea in newborns and the blindness it can cause.
Source: Pinkeye (Conjunctivitis) (kidshealth.org)
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