Frequency of Meningitis in Neonates Presented with Late Onset Sepsis

Objective: To determine the frequency of meningitis among neonates with late onset sepsis (LOS) and identify associated risk factors. Study design: cross-sectional study. Study place and period: Department of Pediatrics, Hameed Latif Hospital, Lahore, over six months from August 2024 to February 2025. Methods: A total of 120 neonates were enrolled with LOS and lumbar puncture was performed. Meningitis was diagnosed based on cerebrospinal fluid criteria: glucose <50% of plasma glucose, white cell count >10/mm³, protein >80 mg/dL, and/or positive culture. Demographic, clinical, and laboratory data were analyzed using SPSS v26.0, with p-value ≤ 0.05 significant. Results: Meningitis was identified in 38.3% (46/120) of neonates with LOS. Mean birth weight (2314.34 ± 380.32 g vs. 3013.10 ± 434.05 g; p-value < 0.001) and APGAR scores (6.50 ± 1.04 vs. 7.59 ± 0.99; p-value < 0.001) were significantly lower in the meningitis group. Preterm delivery (<37 weeks) was more common among affected neonates (63% vs. 44.6%; p-value = 0.049). No significant associations were found with gender, feeding patterns, residence, or delivery mode (p-value> 0.05). Conclusion: Meningitis complicates 38.3% of LOS neonates, with low birth weight and prematurity as significant risk factors. Routine lumbar puncture must be considered in all neonates with LOS for timely diagnosis and management, particularly in resource-limited clinical settings.