Inadequacies of communicating on infants’ newborn charts the potential risks for mother-to-infant infection

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The chart-review study of maternal prenatal and infant newborn records by Kumar et al provides a good starting point for quality improvement at the investigators’ hospital and likely many other hospitals. They document remarkably inadequate written communication of both maternal screening test results and maternal risk factors for transmission of infection to the infant. Of almost 10% of infants born to mothers with documented group B streptococcal colonization and of all infants born to mothers with Chlamydia trachomatis infections, the infants’ charts had recordings of either “unknown” or “negative.” Root causes are failures of systems and of people.

Recognizing the inadequacies of records and the importance of preventing hepatitis B transmission at the time of birth, the Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend reinstating the birth dose of hepatitis B vaccine, using standing orders for vaccination, and requiring placement of a copy of the mother’s test results in the chart. Undoubtedly, this will advance prevention of hepatitis B, but there is work ahead to enhance infants’ outcomes related to other maternal infectious diseases.