The early recognition of early-onset neonatal sepsis can be challenging, especially in developing countries. De Baat et al reported predictors for early-onset sepsis in this setting. The authors are from the Malawi-Liverpool-Wellcome Trust Clinic Research Programme, Emma Children's Hospital, Amsterdam University Medical Center, Liverpool School of Tropical Medicine, Queen Elizabeth Central Hospital (Blantyne), Kamuzu University of Health Sciences, University of Liverpool and the Malawi Ministry of Health.
Patient selection: neonate
Parameters:
(1) gestational age in weeks
(2) birthweight in grams
(3) Apgar score at 5 minutes
(4) maternal VDRL status
(5) premature rupture of the membranes (PROM)
(6) maternal antimicrobial therapy during labor
(7) mode of delivery
(8) place of delivery
(9) congenital malformation
Predictors of Increased Risk
Parameter
Finding
adjusted Odds Ratio (aOR)
gestational age
< 28 weeks
1.84
28 to 31.9 weeks
1.95
32 to 36.9 weeks
1.46
>= 37 weeks
1
birth weight
< 1,000 grams
47.57
1,000 to 1,499
11.31
1,500 to 2499
2.20
>= 2,500
1
5-minute Apgar score
0 to 3
18.60
4 to 6
4.41
7 to 10
1
VDRL status
positive
2.53
other
1
place of delivery
outside of health facility
1.41
Queen Elizabeth Central
1
other primary facility
1.52
secondary facility
2.92
congenital malformations
yes
7.37
no
1
Predictors of Reduced Risk
Parameter
Finding
adjusted Odds Ratio (aOR)
premature rupture
yes
0.43
no
1
antimicrobial therapy
yes
0.36
no
1
mode of delivery
Cesarean section
0.73
vaginal
1
The risk of early-onset neonatal sepsis increases with the number of predictors present.
To read more or access our algorithms and calculators, please log in or register.
