Abstract

ROLE OF MATERNAL RISK FACTORS AND NEONATAL CLINICAL FEATURES IN DIAGNOSIS OF NEONATAL SEPSIS: A CASE CONTROL STUDY

Author(s): Dr. Devi S,

BACKGROUND Sepsis is responsible for 30-50% of the total neonatal deaths in developing countries and is considered the commonest cause of neonatal mortality. Neonatal sepsis has wide range of presentations with number of predisposing factors. Our study aims at detecting the risk factors of neonatal sepsis and to describe the clinical features and laboratory profile of neonates started on intravenous antibiotics for neonatal sepsis. METHODS 120 neonates (60 cases and 60 controls) admitted in the department of child health were enrolled in the present case control study and all cases were subjected to diagnostic evaluation and data was collected using restructured case record forms which included perinatal history, signs and symptoms associated with sepsis and laboratory investigations. Institutional Ethics Committee approved the study and written informed consent was obtained from all consenting mothers. Parameters are expressed as mean (SD) and as proportions. RESULTS 52.5% neonates and 55% cases were males. 25% of cases were preterm deliveries and 21.7% cases were small for gestational age. Premature rupture of membranes (PROM), maternal urinary tract infections (UTI), and gestational diabetes mellitus (GDM) were seen in 16.7%, 10% and 28.3% cases. Hypothermia was a symptom of sepsis in 28.3% while fever was a symptom in 21.7% cases. CRP elevation and toxic granulations were seen in 75% and 33.3% cases. 6.7% cases had a positive blood culture. CONCLUSIONS Manifestations of neonatal sepsis are non-specific. A high index of suspicion with or without laboratory evidences of sepsis is the key for early diagnosis. Prompt institution of antibiotic therapy and supportive care will save most of the cases of neonatal sepsis.