MATERNAL AND NEONATAL FACTORS IDENTIFIED AMONG NEONATES WITH CULTURE-CONFIRMED SEPSIS AT A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN

Background: Neonatal sepsis remains a major cause of neonatal morbidity and mortality worldwide, particularly in low- and middle-income countries. Despite advances in neonatal care, the burden of sepsis remains high due to the presence of preventable maternal and neonatal factors. Early identification of these factors may facilitate timely intervention and improve neonatal outcomes.

Objective: To determine the frequency of maternal and neonatal factors identified among neonates with culture-confirmed neonatal sepsis admitted to a tertiary care hospital.

Methods: This cross-sectional study was conducted in the Department of Pediatrics, Dr. Ruth K.M. Pfau Civil Hospital Karachi, Pakistan, from 9 November 2020 to 10 May 2021. A total of 214 neonates aged 0-28 days with culture-confirmed neonatal sepsis were enrolled through non-probability consecutive sampling. Data regarding maternal and neonatal characteristics were collected using a structured proforma. Maternal factors assessed included inadequate antenatal care, gestational hypertension, urinary tract infection, sexually transmitted infection, premature rupture of membranes, chorioamnionitis, endometritis, and Group B Streptococcus colonization. Neonatal factors included prematurity, low birth weight, low APGAR score at one minute, and resuscitation at birth. Data were analyzed using SPSS version 21. Descriptive statistics were used to summarize study variables.

Results: A total of 214 neonates with culture-confirmed neonatal sepsis were included. The mean maternal age was 26.65 ± 5.83 years, while the mean gestational age and birth weight of the neonates were 34.83 ± 3.78 weeks and 2419.6 ± 727.3 g, respectively. Male neonates accounted for 59.8% of cases. Among maternal factors, inadequate antenatal care was the most frequently observed factor (39.7%), followed by urinary tract infection (34.6%), gestational hypertension (25.2%), premature rupture of membranes (24.8%), sexually transmitted infection (14.5%), chorioamnionitis (9.8%), endometritis (9.3%), and Group B Streptococcus colonization (5.1%). Among neonatal factors, preterm birth was the most common finding (65.0%), followed by resuscitation at birth (62.6%), low birth weight (51.4%), and low APGAR score (50.0%).

Conclusion: Preterm birth, resuscitation at birth, low birth weight, and low APGAR score were the most frequently identified neonatal factors among neonates with culture-confirmed sepsis. Among maternal factors, inadequate antenatal care, urinary tract infection, gestational hypertension, and premature rupture of membranes were the most common findings. Strengthening antenatal care services and improving the identification and management of maternal and neonatal risk conditions may contribute to improved neonatal outcomes.