scholarly journals A study of maternal risk factors associated with early onset neonatal sepsis at tertiary health care centre

2020 ◽  
Vol 13 (2) ◽  
pp. 31-37
Author(s):  
K Jaya Lakshmi ◽  
◽  
Geethashree H C ◽  
Author(s):  
Pramod P. Singhavi

Introduction: Neonatal sepsis can be defined as a clinical condition which is characterized by signs and symptoms of infection in an infant 28 days of life or younger. This is manifested by systemic signs of infection and/ or isolation of a bacterial or other pathogen from the bloodstream. Sepsis is still one of the major causes of morbidity and mortality globally in neonates, despite of recent advances in healthcare units. The incidence of neonatal sepsis by bacteremia in asymptomatic infants is low. In neonatal sepsis we can include septicaemia, pneumonia, meningitis, osteomyelitis, and arthritis and urinary tract infections. The burden for neonatal sepsis was 2,202 (95% CI: 1,099–4,360) per 100,000 live births, with mortality between 11% and 19% and more than 40% of under-five deaths occur in the neonatal period, resulting in 3.1 million new-born deaths each year globally. Material and Methods: The total number neonates admitted in the hospital in given study period was 447, of which 198 were diagnosed for neonatal sepsis by the physician based on the signs and symptoms during admission. The data was collected in three parts: sociodemographic characteristics; maternal information; and part neonatal information for neonatal sepsis. Data was collected in the excel sheet and questionnaires were reviewed and organized by investigators. Results: Of the 198 neonates, 162 (81.8%) infants were in the age range of 0 to 7 days while 36 (18.2%) were aged between 8 and 28 days. Statistically significant difference was observed between early onset and late onset sepsis patients. Out of 198 cases 107 (54%) were male while 91(46%) were female. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 24(14.8%), 21(13.0%), 19(11.7%) and 32 (19.8%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 1(2.8%), 2 (5.6%), 4(11.1%) and 2 (5.6%) cases respectively. Maternal risk factors were identified in 104(64.2%) of early onset sepsis cases while maternal risk factors in late onset sepsis cases were 10(27.8%). Culture positivity was observed in 28 (17.3%) cases of early neonatal sepsis while it was 4 (11.1%) in late onset sepsis. Conclusion: There was male preponderance in early as well as late onset neonatal sepsis. Maternal risk identification may help in the early identification and timely empirical antibiotic therapy. The prediction and/ or diagnosis of neonatal sepsis should be bases on culture-independent diagnostics and risk factor-based scoring systems.


Author(s):  
Pramod P. Singhavi

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.


2019 ◽  
Vol 10 (2) ◽  
pp. 56-58
Author(s):  
Sushant Kumar ◽  
◽  
Vinod Kumar Mishra ◽  
Sunil Kumar ◽  
◽  
...  

2019 ◽  
Vol 10 (2) ◽  
pp. 32-34
Author(s):  
Sudhir Fattepurkar ◽  
◽  
Geeta Fattepurkar ◽  
Narayan Nagmode ◽  
Rekha Kardile ◽  
...  

2011 ◽  
Vol 65 (Suppl 1) ◽  
pp. A344-A344
Author(s):  
C. Maliye ◽  
M. Taywade ◽  
S. Gupta ◽  
P. Deshmukh ◽  
B. Garg

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