Risk factors in early neonatal sepsis.

OBJECTIVE To study the maternal and neonatal risk factors for neonatal sepsis. MATERIALS AND METHODS This is prospective case control study, conducted on the neonates up to 7 days of life with a diagnosis of neonatal sepsis. There were 100 cases of neonatal sepsis and 100 control cases. The neonates in the case and control groups were evaluated for various maternal and neonatal risk factors. RESULTS The factors which carried a significant risk for development of neonatal sepsis were premature rupture of membrane (PROM), meconium stained amniotic fluid (MSAF), foul smelling liquor, low birth weight, prematurity and low Apgar score at birth. The blood culture was positive in 22% of cases. The commonest organisms isolated were S. aureus and Klebsiella. The overall mortality was 11%. The incidence of risk factors was almost equal in culture positive and culture negative cases. CONCLUSION The study identifies PROM, MSAF, foul smelling amniotic fluid, prematurity, low birth weight and low Apgar score at birth as strong risk factors for development of neonatal sepsis. In the presence of above factors, the neonate should be screened and observed for sepsis and considered for early institution of antibiotics.