scholarly journals Risk Factors for Neonatal Sepsis: A Retrospective Case-Control Study among Neonates Who Were Delivered by Caesarean Section at the Trauma and Specialist Hospital, Winneba, Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Peter Adatara ◽  
Agani Afaya ◽  
Solomon Mohammed Salia ◽  
Richard Adongo Afaya ◽  
Anthony K. Kuug ◽  
...  

The third Sustainable Development Goal (SDG) for child health, which targets ending preventable deaths of neonates and children under five years of age by 2030, may not be met without substantial reduction of neonatal sepsis-specific mortality in developing countries. This study aimed at assessing the prevalence and risk factors for neonatal sepsis among neonates who were delivered via caesarean section. A retrospective case-control study was conducted among neonates who were delivered via caesarean section at the Trauma and Specialist Hospital, Winneba, Ghana. Data collection lasted for 4 weeks. The extracted data were double-entered using Epidata software version 3.1 to address discrepancies of data entry. Descriptive statistics such as frequencies and percentages of neonatal characteristics were generated from the data. Both univariate and multivariate logistic regression were used to determine associations between neonatal sepsis and neonatal characteristics with odds ratios, 95% confidence intervals, and p values calculated using variables that showed significant association (p<0.05) in the chi-square analysis for the multivariate logistic regression. A total of 383 neonates were recruited; 67 (17.5%) had sepsis (cases). The neonatal risk factors associated with sepsis were birth weight (χ2=6.64, p=0.036), neonatal age (χ2=38.31, p<0.001), meconium passed (χ2=12.95, p<0.001), reason for CS (χ2=24.27, p<0.001), and the duration of stay on admission (χ2=36.69, p<0.001). Neonatal sepsis poses a serious threat to the survival of the newborn as the current study uncovered 6.0% deaths among sepsis cases. The findings of this study highlight the need for routine assessment of neonates in order to identify risk factors for neonatal sepsis and to curb the disease burden on neonatal mortality.

2021 ◽  
Vol 8 ◽  
Author(s):  
Rongrong Li ◽  
Difei Zhang ◽  
Jingwen He ◽  
Jianjun Ou ◽  
La Zhang ◽  
...  

Background: Fungal peritonitis (FP) is a rare but severe complication that can appear in patients receiving peritoneal dialysis (PD). This study aimed to investigate the incidence rate and clinical characteristics of FP, evaluate clinical outcomes between FP and bacterial peritonitis (BP) patients on PD, and especially estimate the risk factors for FP outbreak.Methods: All episodes of FP diagnosed in our hospital from January 1, 2011, to December 31, 2020, were reviewed in this single-center study. FP cases were analyzed and compared with patients diagnosed with BP in a 1:6 ratio matching for case-control study. Patient information, including clinical information, biochemical analysis, and outcomes, was recorded. Univariate and multivariate logistic regression model were used to analyze the risk factors for FP.Results: A total of 15 FP episodes were observed in 15 PD patients, with an FP rate of 0.0071 episodes per patient-year. Seventeen strains of fungi were isolated and identified. Candida was the most common pathogen (15 strains, 88.2%), followed by Aspergillus fumigatus (2 strains, 11.8%). Between the groups, FP group showed a higher rate of HD transfer and catheter removal, and a lower rate of PD resumption in the short-term outcome (all P &lt; 0.01), while no significant difference in the mortality was noted during the whole study period. The multivariate logistic regression analysis showed that longer PD duration (odds ratio [OR] 1.042, 95% confidence interval [CI] 1.012–1.073, P &lt; 0.01), higher serum potassium (OR 3.373, 95% CI 1.068–10.649, P &lt; 0.05), elevated estimated glomerular filtration rate (eGFR) (OR 1.845, 95% CI 1.151–2.955, P &lt; 0.05), reduced serum albumin level (OR 0.820, 95% CI 0.695–0.968, P &lt; 0.05) and peritoneal effluent polymorphonuclear (PMN) count (OR 0.940, 95%CI 0.900–0.981, P &lt; 0.01) were significantly increased the risk for FP.Conclusion: These results suggested that FP leads to higher rate of catheter removal and HD transfer, and a lower rate of PD resumption than BP, and that additional attention should be paid to hypoalbuminemia, increased serum potassium, long PD duration, and low peritoneal effluent PMN in PD patients.


2019 ◽  
Author(s):  
Hosein Rafiemanesh ◽  
Seyed Rasoul Hashemi Aghdam ◽  
Avaz Safarzadeh ◽  
Sanaz Chapar ◽  
Alireza Zemestani ◽  
...  

Abstract Background Low birth weight (LBW) is one of the main causes of death in children and is an important factor related to the growth and development of children. LBW is associated with causes but some of the risk factors may be due to the country or geographical region. Aim of this study was conducted to investigate the risk factors associated with LBW in the villages of Oskou county, northwest of Iran. Methods This study is a population-based case-control study and all the cases of LBW, that have occurred during the five years 2013-2017 in all villages of Oskou county, East Azerbaijan Province, Iran. Controls were selevted based on systematic random sampling in that same village and year. Chi-square and fisher's exact test analysed and then a univariate and multivariate logistic regression model was used to investigate possible factors. Results In this study 242 cases and 242 control groups were analyzed. Base on multivariate logistic regression important risk factors were LBW history (OR=25.87), mothers who used natural methods of contraception (OR=29.54), twin's birth (OR=24.04) and gestational age less than 37 weeks (OR=3.89). Conclusion According to the result of the present study the most important risk factors of LBW are as follows: Contraception method using, having a history of previous LBW newborn, twin's birth, gestational age, fathers’ occupation, mothers’ education, maternal weight, maternal weight gain during pregnancy and number of of caring during pregnancy.


2021 ◽  
Vol 3 (1) ◽  
pp. 63-70
Author(s):  
Adonis Muganza Nyenga ◽  
◽  
Olivier Mukuku ◽  
Janet Ziazia Sunguza ◽  

Purpose: Neonatal sepsis (NS) is a major cause of neonatal morbidity and mortality, particularly in developing countries. Delays in the identification and treatment of NS are the main contributors to the high mortality. This study aims to identify risk factors for NS in newborns in the two university hospitals in Lubumbashi, in the Democratic Republic of Congo. Methods: This hospital-based case-control study was carried out on 486 mother-newborn pairs using the systematic sampling method during November 2019 to October 2020. Data were analyzed using STATA software (version 15). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results: A total of 162 cases and 324 controls were included in this study. Multiple logistic regression analysis showed that the possible risk factors for NS in this study were low level of education (AOR = 9.16 [2.23-37.67]), maternal genitourinary tract infections (AOR = 42.59 [17.90-101.37]), premature rupture of membranes (AOR = 19.95 [7.27-54.76]), peripartum fever (AOR = 26.25 [2.31-297.83]), prolonged labor (AOR = 14.16 [3.88-51.71]), cesarean section (AOR = 3.57 [1.48-8.61]), obstructed vaginal delivery (AOR = 13.40 [1.32-136.19]), birth weight <1500 grams (AOR = 70.38 [8.64-572.95]), and between 1500-2500 grams (AOR = 7.90 [3.04-20.52]). Conclusion: The study found that maternal and neonatal factors were strongly associated with the risk of developing NS. The present study suggests the possibility of routine assessment of sepsis in newborns born with the above characteristics.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Dan Cao ◽  
Lin Rao ◽  
Jiaqi Yuan ◽  
Dandan Zhang ◽  
Bangchun Lu

Abstract Background Postpartum urinary retention (PUR) may lead to bladder neuromuscular damage and subsequently voiding dysfunction. However, the literature regarding the incidence of and risk factors for PUR remains unclear. Moreover, previously reported studies are limited to small sample sizes. Thus, this study aimed to assess the incidence of and risk factors for overt PUR after vaginal delivery. Methods This retrospective case-control study included all primiparas who delivered vaginally between July 1, 2017, and June 30, 2019, at our institution. The case group comprised 677 women diagnosed with overt PUR who required catheterisation after delivery. The control group comprised 677 women without overt PUR randomly selected in a 1:1 ratio matched for date of delivery and who delivered immediately after each woman with overt PUR to minimise the impact of variations over time in obstetric practice. Univariate and multivariate logistic regression analyses were performed to investigate the factors associated with overt PUR. Results Of the 12,609 women included in our study, 677 were diagnosed with overt PUR (incidence 5.37%). Univariate analysis identified epidural analgesia, episiotomy, perineal tears, instrument-assisted delivery, duration of labour stage, intrauterine operation, and vulvar oedema as risk factors for PUR. Multivariate logistic regression identified epidural analgesia (odds ratio [OR] = 1.41, 95% confidence interval [CI]: 1.11–1.79, P = 0.005), vulvar oedema (OR = 6.92, 95% CI: 4.65–10.31, P < 0.001), forceps delivery (OR = 8.42, 95% CI: 2.22–31.91, P = 0.002), episiotomy (OR = 1.37, 95% CI: 1.02–1.84, P = 0.035), and second-degree perineal tear (OR = 3.42, 95% CI: 2.37–4.94, P < 0.001) as significant independent risk factors for PUR. Conclusions PUR was highly associated with epidural analgesia, forceps delivery, vulvar oedema, episiotomy, and second-degree perineal tears. More attention should be paid to women at high risk to reduce the incidence of PUR.


PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242275
Author(s):  
Md. Abdur Rafi ◽  
M. Morsed Zaman Miah ◽  
Md. Abdul Wadood ◽  
Md. Golam Hossain

Background Sepsis is one of the major causes of neonatal death worldwide as well as in Bangladesh. The objective of the present study was to identify the risk factors and causative organisms of neonatal sepsis after delivery in a tertiary care hospital, Bangladesh. Methods This was a case-control study conducted in the neonatal ward of Rajshahi Medical College Hospital (RMCH), a 1000-bed tertiary hospital situated in Rajshahi, Bangladesh. Neonates diagnosed as neonatal sepsis by clinical and laboratory parameters were included as cases in this study. Admitted neonates unsuspected or undiagnosed for sepsis were considered as controls. Maternal and neonatal information and their laboratory reports were collected and analyzed. Both bivariate and multiple logistic regression models were used to identify the risk factors of neonatal sepsis. Results A total of 91 cases and 193 controls were included in the study. Maternal history of urinary tract infection (UTI) during the third trimester of pregnancy (aOR 2.75, 95% CI: 1.04–7.23, p <0.05), premature birth (aOR 2.77, 95% CI: 1.08–7.13, p <0.05) and APGAR score <7 at five minutes (aOR 2.58, 95% CI: 1.04–6.39, p <0.05) were associated with onset of neonatal sepsis in multiple logistic regression model. All these factors were also associated with developing early-onset neonatal sepsis, while maternal UTI and male sex of neonates were associated with developing late-onset neonatal sepsis. Escherichia coli (40.7%), Staphylococcus aureus (27.5%), and Klebsiella pneumoniae (18.7%) were the commonly isolated organisms causing neonatal sepsis. All these organisms were highly resistant to common antibiotics like amoxicillin, cephalosporins, aminoglycosides and quinolones. Carbapenemase group of drugs along with amikacin, nitrofurantoin and linezolid were the most sensitive drugs. Conclusions Strengthening the existing facility for antenatal screening for early diagnosis and treatment of maternal infection during pregnancy as well as identifying high-risk pregnancy for adequate perinatal management is necessary to prevent neonatal sepsis-related morbidity and mortality. Rational use of antibiotics according to local epidemiology and culture and sensitivity reports may minimize the increasing hazards of antibiotic resistance.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nyenga AM ◽  
◽  
Mukuku O ◽  
Sunguza JZ ◽  
Assumani AN ◽  
...  

Background: Neonatal Sepsis (NS) is a major cause of neonatal morbidity and mortality, particularly in developing countries. Delays in the identification and treatment of NS are the main contributors to the high mortality. This study aims to identify risk factors for NS in newborns in the two university hospitals in Lubumbashi, in the Democratic Republic of Congo. Methods: This hospital-based case-control study was carried out on 486 mother-newborn pairs using the systematic sampling method during November 2019 to October 2020. Data were analyzed using STATA software (version 15). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results: A total of 162 cases and 324 controls were included in this study. Multiple logistic regression analysis showed that the possible risk factors for NS in this study were low level of education (AOR=9.16 [2.23-37.67]), maternal genitourinary tract infections (AOR=42.59 [17.90-101.37]), premature rupture of membranes (AOR=19.95 [7.27-54.76]), peripartum fever (AOR=26.25 [2.31-297.83]), prolonged labor (AOR=14.16 [3.88-51.71]), cesarean section (AOR=3.57 [1.48-8.61]), obstructed vaginal delivery (AOR=13.40 [1.32- 136.19]), birth weight <1500 grams (AOR=70.38 [8.64-572.95]), and between 1500-2500 grams (AOR=7.90 [3.04-20.52]). Conclusion: The study found that maternal and neonatal factors were strongly associated with the risk of developing NS. The present study suggests the possibility of routine assessment of sepsis in newborns born with the above characteristics.


2020 ◽  
Vol 22 (1) ◽  
pp. 6-14
Author(s):  
Matthew I Hardman ◽  
◽  
S Chandralekha Kruthiventi ◽  
Michelle R Schmugge ◽  
Alexandre N Cavalcante ◽  
...  

OBJECTIVE: To determine patient and perioperative characteristics associated with unexpected postoperative clinical deterioration as determined for the need of a postoperative emergency response team (ERT) activation. DESIGN: Retrospective case–control study. SETTING: Tertiary academic hospital. PARTICIPANTS: Patients who underwent general anaesthesia discharged to regular wards between 1 January 2013 and 31 December 2015 and required ERT activation within 48 postoperative hours. Controls were matched based on age, sex and procedure. MAIN OUTCOME MEASURES: Baseline patient and perioperative characteristics were abstracted to develop a multiple logistic regression model to assess for potential associations for increased risk for postoperative ERT. RESULTS: Among 105 345 patients, 797 had ERT calls, with a rate of 7.6 (95% CI, 7.1–8.1) calls per 1000 anaesthetics (0.76%). Multiple logistic regression analysis showed the following risk factors for postoperative ERT: cardiovascular disease (odds ratio [OR], 1.61; 95% CI, 1.18–2.18), neurological disease (OR, 1.57; 95% CI, 1.11–2.22), preoperative gabapentin (OR, 1.60; 95% CI, 1.17–2.20), longer surgical duration (OR, 1.06; 95% CI, 1.02–1.11, per 30 min), emergency procedure (OR, 1.54; 95% CI, 1.09–2.18), and intraoperative use of colloids (OR, 1.50; 95% CI, 1.17–1.92). Compared with control participants, ERT patients had a longer hospital stay, a higher rate of admissions to critical care (55.5%), increased postoperative complications, and a higher 30-day mortality rate (OR, 3.36; 95% CI, 1.73–6.54). CONCLUSION: We identified several patient and procedural characteristics associated with increased likelihood of postoperative ERT activation. ERT intervention is a marker for increased rates of postoperative complications and death.


Oncotarget ◽  
2017 ◽  
Vol 8 (40) ◽  
pp. 66940-66950 ◽  
Author(s):  
Mariusz Dąbrowski ◽  
Elektra Szymańska-Garbacz ◽  
Zofia Miszczyszyn ◽  
Tadeusz Dereziński ◽  
Leszek Czupryniak

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