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Clinical Risk Factors for Early-Onset Sepsis in Neonates: An International Delphi Study
Nazila Moftian1, Taha Samad Soltani1, Kayvan Mirnia2
1Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Iranian Journal of Medical Sciences
|January 23, 2023
Summary
Identifying early-onset sepsis (EOS) risk factors is crucial. Mechanical ventilation and feed intolerance are significant clinical risk factors for neonatal EOS, alongside birth weight, Apgar score, prematurity, gestational age, and infections.
Area of Science:
- Neonatology
- Infectious Diseases
- Clinical Risk Factor Analysis
Background:
- Uncertainty persists regarding modifiable risk factors for neonatal early-onset sepsis (EOS).
- This study aimed to identify potential clinical risk factors for EOS through literature review and expert consensus.
- Establishing clear risk factors is vital for timely intervention and improved neonatal outcomes.
Approach:
- Conducted a comprehensive literature search across major databases (PubMed, Cochrane, Embase, Scopus) up to May 2021.
- Employed the fuzzy Delphi method (FDM) for questionnaire validation and expert opinion synthesis.
- Utilized Chi square tests for statistical validation of identified risk factors in an observational study.
Key Points:
- Mechanical ventilation and feed intolerance were identified as significant risk factors for EOS (P<0.001).
- Cesarean section was not found to be a significant risk factor (P=0.862).
- A total of 26 potential clinical risk factors were determined, including neonatal, maternal, and delivery-related factors.
Conclusions:
- Neonatal factors include birth weight, one-minute Apgar score, and prematurity.
- Maternal factors include gestational age and urinary tract infection.
- Delivery factors include premature rupture of membranes, chorioamnionitis, and intrapartum fever.
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