Risk factors for early neonatal sepsis

Objective: The aim of this study was to identify maternal risk factors for early neonatal sepsis and perinatal outcome in a population of very low birth-weight newborns. Study design: During January 1995 to December 2000, 786 live preterm neonates were born in our institute with birth-weight ≤1,500 g. A cross-sectional study was designed and two groups were identified: 50 neonates who developed early neonatal sepsis and 736 neonates without early sepsis. Results: The prevalence of early sepsis among the neonates was 6.3% (50/786). The following maternal risk factors were significantly associated with early neonatal sepsis: advanced maternal age, high gravidity, the administration of multiple courses of prenatal steroids and tocolytic agents, (i.e., magnesium and indomethacin) and chorioamionitis with premature rupture of membranes. Using a multivariate analysis, the use of tocolytic drugs was found as an independent risk factor for early neonatal sepsis (OR=4.8; 95% CI 1.1–1.6; P=0.019) and so was low gestational age (OR 0.98; 95% CI 0.007–0.017; P=0.017). The following variables of the neonate were significantly associated with early neonatal sepsis: low birth-weight, umbilical blood pH of less than 7.2 and the use of oxygen. Conclusions: The use of tocolytic drugs and low gestational age are independent risk factors for early neonatal sepsis.