Risk factors for early neonatal sepsis

The authors undertook a case-control study of 113 cases of neonatal sepsis and 347 randomly selected controls. All cases and controls were selected from the 1980 and 1981 Washington State birth certificates. The increased risk for males (odds ratio (OR) = 1.75, p = 0.012) and the large risk associated with low birth weight (OR = 99.1, p less than 0.001 if less than 1,500 g and OR = 5.17, p less than 0.001 if 1,500-2,500 g) are consistent with past studies. The relationship of maternal age (OR = 2.00, p = 0.01 if less than or equal to 20 years and OR = 1.74, p = 0.05 if greater than 30) parallels the overall risk of many pregnancy-related complications in these age groups. Interpretation of the elevated risk associated with amniocentesis is hampered by small numbers but is provocative. The strong association of an Apgar score of 6 or less at five minutes (OR = 36.25, p less than 0.001) with neonatal sepsis suggests the possibility of routine sepsis evaluation in such neonates born in areas with high incidence rates of early neonatal sepsis. We found no previous reports associating either abruptio placentae (OR = 12.70, p = 0.028) or preeclampsia (OR = 6.43, p = 0.017) with neonatal sepsis.