Predictors of mortality in outborns with neonatal sepsis: A prospective observational study

Meshram, Rajkumar M.; Gajimwar, Vishal S; Bhongade, Swapnil

doi:10.4103/npmj.npmj_91_19

Cited by 19 publications

(18 citation statements)

References 16 publications

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“…Hypothermia and oxygen saturation < 90% during transportation was an independent predictor of neonatal death. This study is similar to a previous study conducted in Ethiopia [11], Mauritania [28], and India [2,12]. Lack of emergency care on the way to higher centers, poor stabilization before referral and inadequate care during transport increase clinical instability [2,41].…”

Section: Discussionsupporting

confidence: 88%

“…In addition to major causes of neonatal death, some evidence in different parts of the world indicates acute physiologic complications like hypothermia, hypoglycemia, poor peripheral perfusion and other complications related to poor neonatal transport was another challenge for survival and good outcomes of referral neonates. The death occurred about 21.2-79.1% in hypothermic and 60-75.29% in poor peripheral perfusion neonates at admission [12,13]. The incidence of death and hypoglycemia from referred neonates with oxygen saturation < 90% at admission was 60 and 14.6% respectively.…”

Section: Introductionmentioning

confidence: 93%

“…The Sample size was determined by the Fleiss formula using Epi Info7.2.1 by considering significant predicting variables from related works of literature (Table 1). Thus, sample size calculation was based on the following assumptions (Two-sided confidence level = 95%, power = 80% and ratio of exposure to non-exposure = 1:1) and from a prospective follow up study conducted on predictors of mortality in referred neonates with neonatal sepsis at a tertiary care center Maharashtra, India the proportion of neonatal death from hypothermic as exposed and non-hypothermic as non-exposed and odds ratio with non-response rate 10% [12].…”

Section: Sample Size Determinationmentioning

confidence: 99%

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Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study

et al. 2021

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Background Neonatal mortality is a major global public health problem. Ethiopia is among seven countries that comprise 50 % of global neonatal mortality. Evidence on neonatal mortality in referred neonates is essential for intervention however, there is no enough information in the study area. Neonates who required referral frequently became unstable and were at a high risk of death. Therefore, this study aimed to assess the incidence and predictors of mortality among referred neonates. Method A prospective follow-up study was conducted among 436 referred neonates at comprehensive specialized hospitals in the Amhara regional state, North Ethiopia 2020. All neonates admitted to the selected hospitals that fulfilled the inclusion criteria were included. Face-to-face interviews, observations, and document reviews were used to collect data using a semi-structured questionnaire and checklists. Epi-data™ version 4.2 software for data entry and STATA™ 14 version for data cleaning and analysis were used. Variables with a p-value < 0.25 in the bi-variable logistic regression model were selected for multivariable analysis. Multivariable analyses with a 95% confidence level were performed. Variables with P < 0.05 were considered statistically significant. Result Over all incidence of death in this study was 30.6% with 95% confidence interval of (26.34–35.16) per 2 months observation. About 23 (17.83%) deaths were due to sepsis, 32 (24.80%) premature, 40 (31%) perinatal asphyxia, 3(2.33%) congenital malformation and 31(24.03%) deaths were due to other causes. Home delivery [AOR = 2.5, 95% CI (1.63–4.1)], admission weight < 1500 g [AOR =3.2, 95% CI (1.68–6.09)], travel distance ≥120 min [AOR = 3.8, 95% CI (1.65–9.14)], hypothermia [AOR = 2.7, 95% CI (1.44–5.13)], hypoglycemia [AOR = 1.8, 95% CI (1.11–3.00)], oxygen saturation < 90% [AOR = 1.9, 95% (1.34–3.53)] at admission time and neonate age ≤ 1 day at admission [AOR = 3.4, 95% CI (1.23–9.84) were predictors of neonatal death. Conclusion The incidence of death was high in this study. The acute complications arising during the transfer of referral neonates lead to an increased risk of deterioration of the newborn’s health and outcome. Preventing and managing complications during the transportation process is recommended to increase the survival of neonates.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 93%

Section: Sample Size Determinationmentioning

confidence: 99%

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Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study

et al. 2021

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“…In a study conducted by Jajoo et al [23], 14.6% of neonates died. In research done by Meshram et al [24] 174 out of 455 neonates with clinical sepsis died, thus mortality rate being 38.24%. Thus, the mortality rate in our study is comparable to other previously published studies of early-onset sepsis in neonates.…”

Section: Discussionmentioning

confidence: 96%

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

et al. 2021

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Objective: To assess the increased Red Cell Distribution Width (RDW) in diagnosis and prognosis of early-onset neonatal sepsis in term neonates. Methods: In a prospective, observational study, we enrolled term neonates ( 37 weeks of gestation) clinically suspected for Early-Onset Neonatal Sepsis (EONS) (within 7 days of birth). A cut-off of 18% and above was taken to consider RDW as abnormal or increased. The primary outcome was to assess the relation of increased RDW with in-hospital mortality. The secondary outcome was to determine the diagnostic yield of increased RDW in culture-proven sepsis. Results: In 166 neonates, 60% were males. Increased RDW was seen in 42.42% of neonates and 15.75% of neonates had positive blood culture. Compared to normal RDW, in-hospital mortality was significantly higher in neonates with increased mortality (27.14% vs. 10.52%, respectively; p=0.006). Also, abnormal RDW was seen in 46.15% of neonates with positive blood culture compared to 35.25% of neonates with negative blood culture (p<0.0001). Thus, elevated RDW had a sensitivity of 44.4% and specificity of 57.97% in the diagnosis of EONS. Conclusion: Increased RDW can be a diagnostic as well as a prognostic marker in neonates with EONS. Such observation indicates it may serve as a simple and easily available marker for EONS in resource-limited settings. However, these findings need to be confirmed in a larger sample. Doi: 10.28991/SciMedJ-2021-0303-7 Full Text: PDF

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“…Estos resultados son consistentes con los análisis de Duc Vu et al (13), quienes mediante una revisión sistemática concluyeron que los neonatos varones experimentan un mayor peso al nacer. Esta relación fue evidenciada por Meshram et al (14) en población india y por González-Cossío et al (15) en población mexicana.…”

Section: Discussionunclassified

Factores maternos asociados al peso del recién nacido en una IPS de Medellín, Colombia, 2018

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et al. 2021

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Antecedentes: la variabilidad en el peso del recién nacido ya sea como bajo peso o macrosomía, puede ocasionar morbimortalidad infantil y materna, además de ser un predictor del estado de salud a lo largo de la vida. Objetivo: determinar factores sociodemográficos, antecedentes patológicos, exposición a sustancias psicoactivas, actividad física y características alimentarias de la madre relacionados con el peso de los recién nacidos atendidos en una IPS, Medellín 2018. Materiales y métodos: estudio de cohorte con información de madres seguidas hasta el nacimiento de los bebés. Resultados: la edad promedio de las maternas fue de 24±6 años, el peso promedio del recién nacido fue 3150 g. Embarazo previo, consumo de lácteos y derivados, consumo de proteínas y de suplementos dietarios fueron factores presentes en madres de recién nacidos con mayor peso. Haber fumado alguna vez en la vida, antecedente de preeclampsia, parto previo, aborto en el último embarazo y consumo de alimentos ultraprocesados se presentaron en madres de recién nacidos con menor peso. Conclusiones: se recomienda a las gestantes limitar el consumo de alimentos ultraprocesados, supervisar el consumo de lácteos y derivados, proteínas y suplementos dietarios en madres con embarazos previos, antecedente de preclamsia, abortos o hábitos como haber fumado.

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Predictors of mortality in outborns with neonatal sepsis: A prospective observational study

Cited by 19 publications

References 16 publications

Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study

Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

Factores maternos asociados al peso del recién nacido en una IPS de Medellín, Colombia, 2018

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