Clinical Outcomes, Biochemical Markers and Risk Factors Associated with Neonatal Sepsis in Hospitalized Neonates: A Cross-Sectional Study

Risk Factors and Biochemical Markers in Neonatal Sepsis

Abstract

Objective: To evaluate the clinical outcomes, biochemical markers, and associated risk factors among neonates with culture-confirmed sepsis admitted to a tertiary care hospital. Study Design: Cross-sectional study. Settings: Neonatal Nursery Unit, Department of Pediatrics, CMH Kharian Medical College, in collaboration with CMH Kharian Hospital, Pakistan. Duration: Six months from January to June 2024. Methods: A total of 164 neonates with culture-confirmed sepsis were enrolled through consecutive sampling. Demographic characteristics, maternal and neonatal risk factors, clinical manifestations, and biochemical parameters, including C-reactive protein (CRP), serum lactate, and random blood glucose, were recorded using a structured pro forma. Clinical outcomes were categorized as clinical recovery, prolonged ICU stay (>7 days), and in-hospital mortality. Data were analyzed using IBM SPSS Statistics version 25.0. Multivariable binary logistic regression was performed to identify independent predictors of adverse clinical outcomes. Results: Male neonates accounted for 67.7% of the study population, while prematurity and low birth weight were observed in 45.1% and 42.1% of cases, respectively. Prolonged rupture of membranes was the most frequent maternal risk factor (31.1%). Respiratory distress (56.1%) and poor feeding (51.2%) were the predominant clinical manifestations. Elevated CRP (>10 mg/L), serum lactate (>2 mmol/L), and hypoglycemia were significantly associated with prolonged ICU stay and in-hospital mortality. Multivariable logistic regression identified elevated CRP, serum lactate, and hypoglycemia as independent predictors of adverse clinical outcomes. Conclusion: Prematurity, low birth weight, and maternal risk factors were commonly observed among neonates with sepsis. Elevated CRP, serum lactate, and hypoglycemia were independently associated with unfavorable clinical outcomes, highlighting the importance of early biochemical assessment and prompt risk stratification to improve neonatal management.