Ascertainment of risk factors and clinical course for neonates with early onset sepsis in a tertiary care hospital, rural area, Punjab

Abstract

Background: Neonatal sepsis is the most common cause for neonatal mortality and morbidity. Despite advances in neonatal care, the impact of neonatal sepsis remains marked in developing countries. Thus identifying the risk factors is crucial for optimizing neonatal care.Methods: A prospective study was conducted among inborn and outborn neonates with risk factors or clinical features of Early Onset Neonatal Sepsis admitted in nursery and Neonatal intensive care unit, GSMCH, Banur, Distt Patiala, Punjab during the period from August 2014 to January 2015. Outcome variables were the association of neonatal, maternal and environmental factors with Early Onset Neonatal Sepsis (EONS). Overall clinical course in terms of survival/death, Short term outcome of those who survived based on clinical improvement and culture sensitivity report. Analysis was done using percentage, range, mean, standard deviation. Chi square test and multivariate regression analysis was done for comparison between various risk factors and EONS.Results: A total of 85 neonates were enrolled in the study. There were 71 (83.42%) inborn neonates and 14 (16.47%) neonates were outborn. Based on Haematological System Score of >3, sepsis among the inborn neonates was present in 29(40.84%), while in outborn babies sepsis was present in 13 (92.85%) neonates which was statistically significant (p=0.000). Comparison of risk factors like birth asphyxia and unclean vaginal examination showed statistically significant difference (p=0.002; 0.002) between neonates with sepsis and those without sepsis.Conclusions: Neonatal sepsis is a major cause of mortality and morbidity. The study concludes that birth asphyxia and unclean vaginal examination are strong risk factors for early onset neonatal sepsis.