Prevalence, Risk Factors, and Microbial Spectrum of Ophthalmia Neonatorum: A Cross-Sectional Study From Central India

Background Ophthalmia neonatorum (ON) is an acute conjunctival inflammation in neonates that may result in serious complications. Despite advances in intranatal and postnatal care practices, ON remains a significant health concern in several low- and middle-income countries. Aim The main aim of this study is to determine the prevalence, associated risk factors, and causative organisms of ON in neonates at a tertiary care hospital in central India. Methods A hospital-based, cross-sectional study was conducted over 24 months. Medical records of 2,682 neonates were reviewed; 2,450 neonates met the inclusion criteria. ON was defined clinically by conjunctival redness, eyelid swelling, or purulent discharge within 28 days of birth. Results Among the 2,450 neonates whose medical records were included in the study, 74 cases of ON were identified, yielding a prevalence of 3.02%. None of the affected neonates developed serious complications or blindness. The strongest predictors of ON included prolonged rupture of membranes (OR 4.56, p < 0.001), out-of-hospital delivery (OR 6.28, p < 0.001), neonatal intubation (OR 4.78, p < 0.001), and inadequate antenatal visits (fewer than three) (OR 3.08, p < 0.001). Other factors, such as prolonged labour, neonatal resuscitation, and use of orogastric feeding tubes, also showed significant associations. The most frequently isolated organism was Staphylococcus aureus (29.7%), followed by Streptococcus pneumoniae (16.2%), Klebsiella pneumoniae (13.5%), Escherichia coli (6.8%), Pseudomonas aeruginosa (4.1%), and Chlamydia trachomatis (8.1%). About 21.6% of the samples showed no bacterial growth, suggesting either viral causes or self-limiting infections. Conclusions ON remains a notable neonatal morbidity in central India. Strengthening antenatal care, promoting institutional deliveries, and enforcing strict infection-control practices during neonatal interventions are essential to reduce the burden of ON.