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. 2022 Mar;42(3):354-358.
doi: 10.1038/s41372-021-01290-5. Epub 2022 Jan 10.

The association between early-onset sepsis and neonatal encephalopathy

Kathleen P Car  1 , Firdose Nakwa  1 , Fatima Solomon  2   3 , Sithembiso C Velaphi  1 , Cally J Tann  4   5   6 , Alane Izu  2   3 , Sanjay G Lala  1   7 , Shabir A Madhi #  2   3 , Ziyaad Dangor #  8   9   10
Affiliations

The association between early-onset sepsis and neonatal encephalopathy

Kathleen P Car et al. J Perinatol. 2022 Mar.

Abstract

Objective: We evaluated the association between early-onset sepsis and neonatal encephalopathy in a low-middle-income setting.

Methods: We undertook a retrospective study in newborns with gestational age ≥35 weeks and/or birth weight ≥2500 grams, diagnosed with neonatal encephalopathy. Early-onset sepsis was defined as culture-confirmed sepsis or probable sepsis.

Results: Of 10,182 hospitalised newborns, 1027 (10.1%) were diagnosed with neonatal encephalopathy, of whom 52 (5.1%) had culture-confirmed and 129 (12.5%) probable sepsis. The case fatality rate for culture-confirmed sepsis associated neonatal encephalopathy was threefold higher compared to neonatal encephalopathy without sepsis (30.8% vs. 10.5%, p < 0.001). Predictors of mortality for culture-confirmed sepsis associated neonatal encephalopathy included severe neonatal encephalopathy (aOR 6.51, 95%CI: 1.03-41.44) and seizures (aOR 10.64, 95%CI: 1.05-107.39).

Conclusion: In this setting, 5% of neonatal encephalopathy cases was associated with culture-confirmed sepsis and a high case fatality rate.

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