A retrospective study of risk factors for early-onset neonatal sepsis with intrapartum maternal fever

An, Hongmin; Zheng, Wei; Zhu, Qinghua; Chai, Yimin

doi:10.7717/peerj.13834

Cited by 4 publications

(1 citation statement)

References 44 publications

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“…Based on the results presented herein, the occurrence of PIVH does seem to be influenced by the mode of delivery. However, some studies associated cesarean section with reduced risk of PIVH 29 , whereas most studies discuss these conflicting results and the need for further follow-up studies 30 , 31 .…”

Section: Discussionmentioning

confidence: 99%

Early-onset neonatal sepsis as a risk factor for peri-intraventricular hemorrhage in premature infants

Denicol,

Leotti,

Soares

et al. 2024

Rev. bras. epidemiol.

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Objective: To assess early-onset sepsis as a risk factor of peri-intraventricular hemorrhage in premature infants born at less than or equal to 34 weeks’ gestation and admitted to a neonatal intensive care unit (NICU). Methods: This retrospective cohort study included premature patients born at less than or equal to 34 weeks’ gestation who were admitted to the NICU of a tertiary hospital in southern Brazil, and born from January 2017 to July 2021. Data were collected from patients’ medical records. Early-onset sepsis was measured according to the presence or absence of diagnosis within the first 72 hours of life, whereas the outcome, peri-intraventricular hemorrhage, was described as the presence or absence of hemorrhage, regardless of its grade. Results: Hazard ratios were calculated using Cox regression models. A total of 487 patients were included in the study, of which 169 (34.7%) had some degree of peri-intraventricular hemorrhage. Early-onset sepsis was present in 41.6% of the cases of peri-intraventricular hemorrhage, which revealed a significant association between these variables, with increased risk of the outcome in the presence of sepsis. In the final multivariate model, the hazard ratio for early-onset sepsis was 1.52 (95% confidence interval 1.01–2.27). Conclusion: Early-onset sepsis and the use of surfactants showed to increase the occurrence of the outcome in premature children born at less than or equal to 34 weeks’ gestation. Meanwhile, factors such as antenatal corticosteroids and gestational age closer to 34 weeks’ gestations were found to reduce the risk of peri-intraventricular hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Early-onset neonatal sepsis as a risk factor for peri-intraventricular hemorrhage in premature infants

Denicol,

Leotti,

Soares

et al. 2024

Rev. bras. epidemiol.

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

Guo,

Han,

et al. 2023

The Journal of Maternal-Fetal & Neonatal Medicine

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Maternal factors associated with early-onset neonatal sepsis among term babies delivered by caesarean section: a case-control study at Mbarara Regional Referral Hospital, Uganda

Maisaba,

Migisha,

Owaraganise

et al. 2024

Preprint

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Background: Babies born by caesarean section in low-income settings are at increased risk for early-onset neonatal sepsis (EONS), which has higher mortality than late-onset sepsis. However, maternal factors contributing to EONS among cesarean-delivered babies in these settings, including Uganda, are not well documented. We determined maternal factors associated with EONS among term babies delivered by caesarian section at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda. Methods: We conducted an unmatched case-control study at MRRH from December 2019 to March 2020. Cases were term newborns delivered by caesarean section with EONS (within 72 hours). Controls were term newborns delivered by cesarean section at MRRH without EONS. We enrolled mother-baby pairs for both groups, obtaining maternal data via structured questionnaires The diagnosis of EONS was made using the WHO Young Infant Integrated Management of Childhood Illnesses algorithm. Cases were consecutively recruited while controls were recruited by simple random sampling in a ratio of 1:2. We used multivariable logistic regression analysis to identify maternal factors associated with EONS. Results: We enrolled 52 cases and 104 controls. The mean age for the mothers was 27 (±5.5) years. Neonates born to referred mothers had higher odds of EONS than those born to non-referred mothers (AOR=6.21, 95% CI: 1.81–21.31). Additionally, decision-to-delivery time >1 hour for emergency caesarean section (AOR=16.44, 95% CI: 4.17–64.8), antepartum hemorrhage (AOR=7.97, 95% CI: 1.59–39.95, p=0.012), primiparity (AOR=4.81, 95% CI: 1.11–20.78), and >3 vaginal examinations after membrane rupture (AOR=4.25, 95% CI: 1.54 - 11.72) were associated with EONS. Conclusions: Prime gravidity, antepartum hemorrhage, multiple vaginal examinations after membrane rupture, long decision-to-delivery time, and referral status were associated with EONS among term babies delivered by caesarean section at MRRH. To reduce EONS risk, clinicians should limit post-membrane rupture vaginal exams or consider prophylactic antibiotics if multiple exams are needed. Screening babies born to primiparous women, those referred, those with antepartum hemorrhage, multiple vaginal exams after membranes rupture, and long decision-to-delivery times, could aid prompt recognition of EONS and timely interventions. Implementing standard procedures to reduce caesarean decision-to-delivery time could reduce risk for EONS in this setting.

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A retrospective study of risk factors for early-onset neonatal sepsis with intrapartum maternal fever

Cited by 4 publications

References 44 publications

Early-onset neonatal sepsis as a risk factor for peri-intraventricular hemorrhage in premature infants

Early-onset neonatal sepsis as a risk factor for peri-intraventricular hemorrhage in premature infants

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

Maternal factors associated with early-onset neonatal sepsis among term babies delivered by caesarean section: a case-control study at Mbarara Regional Referral Hospital, Uganda

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