Neonatal Sepsis in Preterm Low Birth Weight Infants Born to Mothers with Genitourinary Infections: A Hospital-Based Microbiological and Clinical Outcomes Study

Background: Neonatal sepsis remains a major cause of morbidity and mortality among preterm low birth weight (LBW) infants, particularly in developing countries. Maternal genitourinary infections during pregnancy are recognized risk factors for vertical transmission of pathogenic microorganisms, increasing the susceptibility of neonates to early-onset sepsis. Objectives: To evaluate the microbiological profile, clinical outcomes, and risk factors associated with neonatal sepsis in preterm low birth weight infants born to mothers with documented genitourinary infections. Materials and Methods: A hospital-based prospective observational study was conducted in the Neonatal Intensive Care Unit (NICU) of a tertiary care teaching hospital over a study period of 18 months. A total of 120 preterm low birth weight neonates born to mothers diagnosed with genitourinary infections during pregnancy were enrolled. Clinical evaluation, laboratory investigations, blood culture findings, and neonatal outcomes were recorded. Statistical analysis was performed using SPSS version 26.0. Results: Among 120 enrolled neonates, 38 (31.7%) developed culture-confirmed neonatal sepsis. Early-onset sepsis constituted 71.1% of cases. Gram-negative organisms were predominant, with Klebsiella pneumoniae (31.6%) being the most common isolate followed by Escherichia coli (23.7%). Neonates with birth weight below 1500 g and gestational age less than 32 weeks showed significantly higher sepsis rates (p<0.05). Respiratory distress, prolonged NICU stay, and mortality were significantly associated with septic neonates. Overall mortality among septic neonates was 18.4%. Conclusion: Maternal genitourinary infections significantly contribute to neonatal sepsis in preterm low birth weight infants. Early identification and management of maternal infections along with timely neonatal screening may reduce adverse outcomes and mortality.