PROPORTION OF EARLY ONSET SEPSIS IN LOCAL NICU AND IDENTIFICATION OF MATERNAL RISK FACTORS
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.1127Keywords:
Sepsis, Neonates, Maternal Risk FactorsAbstract
Early onset neonatal sepsis (EOS) remains a significant cause of morbidity and mortality in neonatal intensive care units (NICUs). Identifying maternal risk factors associated with EOS is crucial for early diagnosis and prevention. Objective: To evaluate the prevalence of early onset sepsis in neonates admitted to the local neonatal intensive care unit (NICU) and identify maternal risk factors associated with neonatal sepsis. Methods: A comparative cross-sectional study was conducted at the Pediatrics Department, Combined Military Hospital Peshawar, from January 2021 to May 2022. One thousand neonates admitted to the NICU due to any indication were included. A consultant paediatrician or neonatologist diagnosed neonatal sepsis based on clinical signs and laboratory findings. Maternal factors such as age, premature rupture of membranes (PROM), maternal fever, and chorioamnionitis were analyzed for their association with early onset sepsis. Data were statistically analysed using SPSS, with p-value <0.001 considered significant. Results: Out of 1000 neonates, 690 (69%) were male and 310 (31%) were female. The mean maternal age was 33.38 ± 4.53 years. EOS was observed in 123 neonates (12.3%), while 877 (88.7%) neonates showed no signs of sepsis. PROM and chorioamnionitis were significantly associated with early-onset sepsis (p-value <0.001). Conclusion: Early onset neonatal sepsis is a common condition in neonates admitted to the NICU. Neonates born to mothers with PROM or chorioamnionitis were at a significantly higher risk of developing EOS. These findings emphasise the importance of addressing maternal risk factors in reducing the incidence of neonatal sepsis.
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Al-Wassia H, Saber M. Admission of term infants to the neonatal intensive care unit in a Saudi tertiary teaching hospital: cumulative incidence and risk factors. Ann Saudi Med. 2017;37(6):420‐424. doi:10.5144/0256-4947.2017.420
Quddusi AI, Razzaq A, Hussain S, Hussain A. Pattern of neonatal admission at the Children's Hospital and the Institute of Child Health, Multan. J Ayub Med Coll Abbottabad. 2012;24(2):108‐110
Chow S, Chow R, Popovic M, et al. A Selected Review of the Mortality Rates of Neonatal Intensive Care Units. Front Public Health. 2015;3:225. Published 2015 Oct 7. doi:10.3389/fpubh.2015.00225
Fisher AL, Sangkhae V, Presicce P, Chougnet CA, Jobe AH, Kallapur SG, et al. Fetal and amniotic fluid iron homeostasis in healthy and complicated murine, macaque, and human pregnancy. JCI Insight. 2020 Feb 27;5(4):e135321. doi: 10.1172/jci.insight.135321. PMID: 31990688; PMCID: PMC7101151.
Salman M, Rathore H, Arif S, Ali R, Khan AA, Nasir M. Frequency of Immediate Neonatal Complications (Hypoglycemia and Neonatal Jaundice) in Late Preterm and Term Neonates. Cureus. 2021 Jan 5;13(1):e12512. doi: 10.7759/cureus.12512. PMID: 33564518; PMCID: PMC7863071.
Khowaja WH, Leghari AL, Hussain AS, Ariff S, Khan IA. Frequency and Early Complications of Late Preterm Infants: A Descriptive Analysis from Two Secondary-care Hospitals of Karachi. Cureus. 2019 Sep 28;11(9):e5789. doi: 10.7759/cureus.5789. PMID: 31728236; PMCID: PMC6827863.
Sands K, Spiller OB, Thomson K, Portal EAR, Iregbu KC, Walsh TR. Early-Onset Neonatal Sepsis in Low- and Middle-Income Countries: Current Challenges and Future Opportunities. Infect Drug Resist. 2022;15(3):933-946. Published 2022 Mar 9. doi:10.2147/IDR.S294156
Flannery DD, Mukhopadhyay S, Morales KH, Dhudasia MB, Passarella M, Gerber JS et al. Delivery Characteristics and the Risk of Early-Onset Neonatal Sepsis. Pediatrics. 2022;149(2):e2021052900. doi:10.1542/peds.2021-052900
Dirirsa DE, Dibaba Degefa B, Gonfa AD. Determinants of neonatal sepsis among neonates delivered in Southwest Ethiopia 2018: A case-control study. SAGE Open Med. 2021;9(1):20503121211027044. Published 2021 Jun 24. doi:10.1177/20503121211027044
Atif M, Zia R, Malik I, Ahmad N, Sarwar S. Treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending Bahawal Victoria Hospital, Pakistan. PLoS ONE. 2021;16(1): e0244866. https://doi.org/10.1371/journal.pone.0244866
Camargo JF, Caldas JPS, Marba STM. Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more. Rev Paul Pediatr. 2021;40(2):e2020388. Published 2021 Oct 4. doi:10.1590/1984-0462/2022/40/2020388
Rafi MA, Miah MMZ, Wadood MA, Hossain MG. Risk factors and etiology of neonatal sepsis after hospital delivery: A case-control study in a tertiary care hospital of Rajshahi, Bangladesh. PLoS ONE. 2020;15(11): e0242275. https://doi.org/10.1371/journal.pone.0242275
Ghafoor S. Current and Emerging Strategies for Prediction and Diagnosis of Prelabour Rupture of the Membranes: A Narrative Review. Malays J Med Sci. 2021;28(3):5-17. doi:10.21315/mjms2021.28.3.2
Conde-Agudelo A, Romero R, Jung EJ, Garcia Sánchez ÁJ. Management of clinical chorioamnionitis: an evidence-based approach. Am J Obstet Gynecol. 2020;223(6):848-869. doi:10.1016/j.ajog.2020.09.044
Alemu M, Ayana M, Abiy H, Minuye B, Alebachew W, Endalamaw A. Determinants of neonatal sepsis among neonates in the northwest part of Ethiopia: case-control study. Ital J Pediatr. 2019;45(1):150. Published 2019 Nov 28. doi:10.1186/s13052-019-0739-2
Stoll BJ, Puopolo KM, Hansen NI, Sanchez PJ, Bell EF, Carlo WA et al. Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli, and the Need for Novel Prevention. JAMA Pediatr. 2020;174(7):e200593. doi:10.1001/jamapediatrics.2020.0593
Manandhar S, Amatya P, Ansari I, Joshi N, Maharjan N, Dongol S et al. Risk factors for the development of neonatal sepsis in a neonatal intensive care unit of a tertiary care hospital of Nepal. BMC Infect Dis. 2021;21(3):546-556. https://doi.org/10.1186/s12879-021-06261-x
Adatara P, Afaya A, Salia SM, Afaya RA, Konlan KD, Agyabeng-Fandoh E et al. Risk Factors Associated with Neonatal Sepsis: A Case Study at a Specialist Hospital in Ghana. ScientificWorldJournal. 2019;2019:9369051. Published 2019 Jan 1. doi:10.1155/2019/9369051
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