DOI: 10.4103/mj.mj_17_25 ISSN: 2070-1128

First day Predictors of Mortality in Neonates with Early onset Sepsis: A Case–control Study from Baghdad

Nabeeha Najatee Akram, Banan Wadi Ahmed, Ahmed Khaldoon Yaseen, Shaymaa Khalid Abdulqader

Abstract

Context:

Early-onset neonatal sepsis (EONS) is one of the leading causes of death in the neonatal period.

Aims:

To identify maternal and neonatal risk factors in the 1 st day of life that predicts mortality in neonates with EONS.

Patients and Methods:

A case–control study included neonates with an EONS who were admitted to the neonatal intensive care unit in tertiary hospital in Baghdad-Iraq from May 2023 to May 2024. All patients included in the study have had blood withdrawn for septic screening in the 1 st day of life and subsequently carried the diagnosis of EONS by positive blood culture results. According to the fate of the patients, the study sample was divided into two groups: a case group composed of newborns with early sepsis who died and a control group made up of newborns who survived hospital care. Neonatal and maternal factors with possible influence on the fate of neonates were analyzed and compared between both groups.

Results:

A total of 168 neonates were included in the study, 50 neonates died with reported death rate of (42.4%). The deceased neonates had a significantly earlier time of blood withdrawal for investigation than the survived neonate P = 0.008. The clinical presentation was significantly different between the two groups, P = 0.005. Lower maternal hemoglobin showed a protective effect against neonatal mortality from EONS P = 0.031. Apgar scores on 1 and 5 min were both significantly lower in deceased neonates P = 0.011, <0.001, respectively, and on multivariate analysis score ≤3 was the only predictive factors for death.

Conclusions:

Mortality rates from EONS are an alarmingly high and closely related to maternal and neonatal factors. Apgar scores ≤3 at 1 st and 5 th min can serve as the early predictors of death in neonates with EONS.

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