Prevalence, Maternal Risk Factors, and Neonatal Outcomes of Early-Onset Neonatal Septicemia: A Retrospective Study

Introduction Neonatal infections continue to pose major challenges in intensive care settings. This study aimed to evaluate the prevalence, maternal risk factors, neonatal characteristics, and clinical outcomes associated with early-onset neonatal septicemia in neonates admitted to the neonatal intensive care unit. Materials and methods This retrospective observational cohort study was conducted in the neonatal intensive care unit at Government Medical College, Hingoli, India, using medical records of neonates admitted between January 2019 and December 2024. A total of 128 neonates aged 0-28 days were included in the study. Maternal variables, such as preterm delivery, prolonged membrane rupture, intrapartum fever, chorioamnionitis, and maternal urinary tract infection, were assessed. Neonatal variables, including birth weight, Apgar score, resuscitation at birth, and clinical outcomes, were evaluated. Early-onset neonatal septicemia was defined as clinical signs of sepsis occurring within the first 72 hours of life, with a positive blood culture and/or positive sepsis screening parameters. Statistical analysis was performed, and statistical significance was set at p < 0.05. Results The prevalence of early-onset neonatal septicemia was found in 21 neonates (16.4%), including proven sepsis in 13 neonates (10.2%) and probable sepsis in eight neonates (6.2%). Preterm delivery, prolonged membrane rupture, intrapartum fever, and chorioamnionitis were significantly associated with early-onset neonatal septicemia (p < 0.05). Low birth weight was observed in 17 neonates (81.0%) with sepsis compared with 41 neonates (38.3%) without sepsis (p < 0.001). Mechanical ventilation was required in 11 neonates (52.4%), while in-hospital mortality was observed in four neonates (19.0%) with early-onset neonatal septicemia. Multivariate logistic regression analysis identified prolonged rupture of membranes (aOR: 4.67), intrapartum fever (aOR: 3.89), preterm delivery (aOR: 3.21), low birth weight (aOR: 2.98), and a five-minute Apgar score <7 (aOR: 2.42) as independent predictors of early-onset neonatal septicemia. Conclusion Early-onset neonatal septicemia remains a significant cause of neonatal morbidity and mortality in neonatal intensive care units. Prolonged rupture of membranes, intrapartum fever, preterm delivery, low birth weight, and a low five-minute Apgar score were identified as independent predictors of early-onset neonatal septicemia. Early identification of high-risk neonates and timely management strategies may improve neonatal outcomes.