DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20204049

Predictors of mortality in neonatal septicemia in a tertiary care centre

Dhara Gosai, Bela H. Shah, Jyothi S.

Abstract


Background: Neonatal septicemia continues to be a major cause of mortality and morbidity in new-borns all over the world. Aim and objectives of the study were determining the risk factors for mortality in neonatal septicemia.

Methods: A retrospective observational study of the demographics, clinical features and laboratory parameters of 100 neonates admitted in NICU of a tertiary care hospital from September 2019 to March 2020.

Results: 67% of neonates delivered outside centre and 33% of neonates delivered at centre were found to have sepsis exclusively based on culture positivity. A significant association was found between very low birth rate (VLBW) (p value<0.001), prematurity (p value<0.01) and high neonatal mortality. Among the different clinical presentations of neonatal sepsis, lethargy (p value<0.02), apnea (p value<0.01) and hypothermia (p value<0.02) were found to be frequently associated with neonatal mortality. Further, C-reactive proteinĀ (CRP) positivity (p value<0.003), hyperglycaemia (p value<0.0009) and thrombocytopenia (p value<0.0009) were also associated with high neonatal mortality. Gram positive bacteria were frequently isolated from blood cultures of deceased neonates, Coagulase negative staphylococci (CoNS) (36.1%), being the commonest bacteria followed by B. subtilis (11.1%), Klebsiella spp. (11.1%) and Acinetobacter spp. (8.3%).

Conclusion: Demographic factors like VLBW, prematurity, outborn deliveries, clinical and laboratory parameters like lethargy, apnea, hypothermia, thrombocytopenia and hyperglycemia are strong predictors of mortality in neonatal.


Keywords


Morbidity, Neonatal mortality, Septicemia

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