Neonatal Sepsis Risk Factors in Public Hospitals in Wollega Zones, Ethiopia

Abstract

Background

Globally, neonatal death accounts for almost half of the under-five children’s mortality rate. In Ethiopia, neonatal sepsis is among the leading causes of neonatal morbidity and mortality. Several studies had assessed the prevalence and associated factors of neonatal sepsis in Ethiopia. However, limited studies examined the risk factors of neonatal sepsis. Thus, this study aimed to assess risk factors for neonatal sepsis among neonates admitted to the neonatal intensive care unit of the selected public hospitals in Wollega Zones.

Methods

A hospital-based unmatched case-control study was conducted in public hospitals in Wollega zones among 300 newborns admitted to neonatal intensive care units with their index mothers. Neonatal sepsis was diagnosed by a physician based on hematologic records and newborn danger signs. Neonates who were diagnosed for neonatal sepsis were recorded to cases; meanwhile, controls were who had not had sepsis. The consecutive sampling technique was employed to collect data from the study subjects using a 1:1 ratio for cases and controls. The data were entered into Epi Data version 3.1 and exported to SPSS version 20 for analysis. The binary logistic regression model was used to examine the association between dependent and independent variables. Variables were considered as an independent risk factor of neonatal sepsis if the p-value is <0.05 in stepwise backward analysis in multivariable logistic regression.

Findings

Three hundred neonates with their index mothers (150 cases and 150 controls) were included in this study. Multivariable logistic regression analysis showed that mothers who had experienced premature rupture of the membrane [AOR=2.94, 95% CI(1.39-6.06)], mothers who had a history of UTI/STI [AOR=2.11, 95% CI(1.06-4.19)], neonates’ who had APGAR scores of <7 at the fifth minute [AOR=3.69, 95% CI(2.08-6.53)] and neonates who was resuscitated at birth [AOR=2.93, 95% CI(1.67-5.14)] were the independent risk factors of neonatal sepsis to neonates admitted to neonatal intensive care units.

Conclusions

This study highlights both maternal and neonatal factors contributing to neonatal sepsis. Maternal counseling, early identification and prompt management of maternal urinary tract infections/sexually transmitted infections during antenatal care service should be emphasized. Also, enhancing safe neonatal resuscitation and infection prevention practice of delivery unit staff through provision of refreshment course.

DOI: 10.7176/JHMN/87-02

Publication date:March 31^st 2021