October 1, 1997American Journal of Perinatology
Early-Onset Neonatal Sepsis in Pakistan: A Case Control Study of Risk Factors in a Birth Cohort
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Discussion
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Implication
Case-control study identifies maternal infection and lack of exclusive breastfeeding as risk factors for early-onset neonatal sepsis, highlighting key targets for intrapartum care.
Key Points
- Identify maternal and infant risk factors associated with early-onset neonatal bacterial sepsis.
- Prospective case-control study conducted among inborn infants at a medical centre in Karachi, Pakistan, between 1990 and 1993.
- Identified 38 infants with blood culture-proven bacterial sepsis within 72 hours of birth (prevalence: 5.6 per 1,000 live births) matched 1:2 to consecutive gender-matched uncomplicated births.
- The predominant bacterial isolates were Staphylococcus aureus (18%), group B Streptococci (13%), and Klebsiella pneumoniae (13%).
- Significant maternal risk factors included urinary tract infection (OR 20, 95% CI 2.4–166.9), pyrexia (P < 0.0001), vaginal discharge (P < 0.05), and vaginal examinations during labor (P = 0.03).
- Infected newborns had significantly lower Apgar scores (P < 0.0001), higher intubation rates at birth (P = 0.04), and significantly reduced odds of exclusive breastfeeding (OR 0.33, 95% CI 0.1–0.8).
Cite This Study
Bhutta et al. (1997) studied this question.