Determinants of Late-Onset Sepsis in Preterm Babies in the Department of Neonatology

Abdullah Bin Munir; Nadia Nawaz; Zahid Jamil; Rabia Ahmed; Muhammad Ikhlaq

doi:10.54112/bcsrj.v6i8.2353

Authors

Abdullah Bin Munir Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences Lahore, Pakistan
Nadia Nawaz Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences Lahore, Pakistan
Zahid Jamil Department of Neonatology, The Children’s Hospital, University of Child Health Sciences Lahore, Pakistan
Rabia Ahmed Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences Lahore, Pakistan
Muhammad Ikhlaq Department of Paediatrics, Holy Family Hospital Rawalpindi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i8.2353

Keywords:

Late-onset sepsis; Preterm neonates; Low birth weight; Bottle feeding; Cord care

Abstract

Late-onset sepsis is an important cause of morbidity and mortality among preterm neonates, particularly in resource-limited settings. Biological immaturity, inappropriate feeding practices, poor hygiene, inadequate cord care, and previous antimicrobial exposure may contribute to its occurrence. Objective: To determine the frequency and distribution of potential determinants of late-onset sepsis among preterm neonates presenting to a tertiary-care neonatal department. Methods: This hospital-based cross-sectional study was conducted in the Department of Neonatology, The Children’s Hospital and University of Child Health Sciences, Lahore, Pakistan, from 3 December 2024 to 3 June 2025. A total of 200 preterm neonates of either sex, aged 7–28 days, with culture-confirmed late-onset sepsis were enrolled through non-probability consecutive sampling. Demographic, birth-related, feeding, hygiene, cord-care, and previous antimicrobial-exposure data were collected using a structured proforma. Data were analysed using IBM SPSS Statistics version 22.0 and presented as means, standard deviations, frequencies, and percentages. Results: The mean age at presentation was 15.24 ± 5.31 days, the mean gestational age was 34.63 ± 1.39 weeks, and the mean birth weight was 2.12 ± 0.37 kg. Of the neonates, 117 (58.5%) were male, 126 (63.0%) were urban residents, and 104 (52.0%) belonged to families of low socioeconomic status. Low birth weight was the most frequently identified potential determinant, affecting 136 (68.0%) neonates, followed by poor hygiene in 92 (46.0%), bottle feeding in 78 (39.0%), previous antimicrobial exposure in 72 (36.0%), poor cord care in 64 (32.0%), poor five-minute Apgar score in 61 (30.5%), and formula feeding with a spoon in 47 (23.5%). Overall, 166 (83.0%) neonates had at least two potential determinants, while 103 (51.5%) had two or more potentially modifiable determinants. Conclusion: Low birth weight was the most common potential determinant among preterm neonates with late-onset sepsis. The frequent coexistence of poor hygiene, unsafe feeding practices, inadequate cord care, and previous antimicrobial exposure indicates the need for integrated preventive strategies targeting both neonatal vulnerability and modifiable caregiving practices.

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