Description

The early recognition of early-onset neonatal sepsis can be challenging, especially in developing countries. De Baat et al reported predictors for early-onset sepsis in this setting. The authors are from the Malawi-Liverpool-Wellcome Trust Clinic Research Programme, Emma Children's Hospital, Amsterdam University Medical Center, Liverpool School of Tropical Medicine, Queen Elizabeth Central Hospital (Blantyne), Kamuzu University of Health Sciences, University of Liverpool and the Malawi Ministry of Health.


Patient selection: neonate

 

Parameters:

(1) gestational age in weeks

(2) birthweight in grams

(3) Apgar score at 5 minutes

(4) maternal VDRL status

(5) premature rupture of the membranes (PROM)

(6) maternal antimicrobial therapy during labor

(7) mode of delivery

(8) place of delivery

(9) congenital malformation

 

Predictors of Increased Risk

 

Parameter

Finding

adjusted Odds Ratio (aOR)

gestational age

< 28 weeks

1.84

 

28 to 31.9 weeks

1.95

 

32 to 36.9 weeks

1.46

 

>= 37 weeks

1

birth weight

< 1,000 grams

47.57

 

1,000 to 1,499

11.31

 

1,500 to 2499

2.20

 

>= 2,500

1

5-minute Apgar score

0 to 3

18.60

 

4 to 6

4.41

 

7 to 10

1

VDRL status

positive

2.53

 

other

1

place of delivery

outside of health facility

1.41

 

Queen Elizabeth Central

1

 

other primary facility

1.52

 

secondary facility

2.92

congenital malformations

yes

7.37

 

no

1

 

Predictors of Reduced Risk

 

Parameter

Finding

adjusted Odds Ratio (aOR)

premature rupture

yes

0.43

 

no

1

antimicrobial therapy

yes

0.36

 

no

1

mode of delivery

Cesarean section

0.73

 

vaginal

1

 

The risk of early-onset neonatal sepsis increases with the number of predictors present.


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