Neonatal sepsis risk factors in public hospitals in Wollega zones, Ethiopia: case control study

Abstract

Introduction: 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. Therefore, this study aimed to assess maternal and neonatal risk factors for neonatal sepsis among neonates admitted to the neonatal intensive care unit of the selected public hospitals in Wollega Zones. Methods: hospitals based case-control study was conducted in public hospitals in Wollega zones among 300 newborns admitted to neonatal intensive care units with their index mothers. Cases were diagnosed with one of the newborn danger igns and by hematologic criteria suggestive for neonatal sepsis. Controls were neonates admitted with other medical diagnoses and do not fulfill neonatal sepsis criteria. 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 identify a significant predictor of cases at pvalue <0.05. Results: three hundred neonates with their index mothers (150 cases and 150 controls) were included in this study. Mothers who experienced PROM (AOR=2.47, 95% CI: 1.16-5.25), had UTI/STI history (AOR=2.29, (1.17-4.49), 95% CI: 1.17-4.49), neonates who had Apgar scores of <7 at the fifth minute (AOR=4.27, 95% CI: 2.44-7.46) and those who resuscitated at birth (AOR=2.58, 95% CI: 1.49-4.45) were independent predictors of neonatal sepsis. Conclusion: this study highlighted risk factors of neonatal sepsis associated with mothers and neonates. Maternal screening and counseling during antenatal care visits about pregnancyrelated complications, and safe newborn care by healthcare workers needs to be emphasized.