Perinatal risk factors for neonatal early-onset sepsis: a meta-analysis of observational studies

Abstract

Objective Early-onset neonatal sepsis (EONS) remains an important cause of neonatal mortality and has many risk factors, therefore, this study aimed to investigate the perinatal risk factors for EONS. Methods We searched CNKI, Wan Fang, VIP, CBM, PubMed, Embase, and Web of Science to compile studies regarding the incidence of neonatal early-onset sepsis, published up to 1 May 2022. To evaluate the quality of the included studies, we used the Newcastle-Ottawa Scale, and the RevMan5.3 software was used for meta-analysis. Results A total of 17 studies were included, with 1987 cases in the case group and 4814 cases in the control group. Meta-analysis showed that perinatal asphyxia or intrauterine distress (OR = 3.00, 95% CI: 2.18–4.13), amniotic fluid meconium contamination (OR = 4.51, 95% CI: 2.31–8.81), group B streptococcal (GBS) colonization in pregnant women (OR = 2.13, 95% CI: 1.48–3.05), chorioamnionitis (OR = 4.58, 95% CI: 2.61–8.05), premature rupture of membranes (OR = 2.63, 95% CI: 2.09–3.30), lower gestational age (OR = 1.31, 95% CI: 1.18–1.44), maternal urinary or reproductive tract infection (OR = 3.61, 95% CI: 2.14–6.11), perinatal fever (OR = 3.59, 95% CI: 2.25–5.71), very low birth weight (OR = 3.79, 95% CI: 2.14–6.73), and vaginal examination ≥3 times (OR = 7.95, 95% CI: 4.04–15.64) were the perinatal risk factors for EONS. Conclusion Perinatal asphyxia or intrauterine distress, meconium contamination in amniotic fluid, GBS colonization in pregnant women, chorioamnionitis, premature rupture of membranes, lower gestational age, maternal urinary tract or reproductive tract infection, perinatal fever, very low birth weight, and vaginal examinations ≥3 times may increase the risk of EONS.