Risk factors for death caused by early onset sepsis in neonates: a retrospective cohort study

OBJECTIVE: To evaluate the association between traditional laboratory findings and death, and to find risk factors for death in infants with early onset sepsis (EOS). STUDY DESIGN: This was a single-center, case–control, retrospective trial conducted between January 2020 and August 2021. Infants with EOS were enrolled and divided into two groups based on outcome before hospital discharge: non-survivors (Mortality group) and survivors (Survival group). RESULTS: Out of 556 eligible neonates, there were 38 (6.8%) deaths. After univariate analysis and ROC curve analysis, there were a total of 12 values with significant differences (p < 0.05) between two groups, which included birth weight (BW), weight on admission, gestational age, age on admission, mode of delivery, septic shock, heart failure, respiratory failure, pulmonary hypertension, hypothermia, serum lactic acid, and aspartate aminotransferase (AST). Moreover, after multivariate analysis performed for those 12 values, the binary logistic regression analysis showed that taking death as a reference, the BW (OR = 1.00, 95% CI[1.001, 1.002], p < 0.001), PPHN (OR = 2.60, 95% CI[1.04, 6.52], p > 0.001), septic shock (OR = 6.15, 95% CI [2.52, 15.00], p < 0.001), heart failure (OR = 6.22, 95% CI[0.90, 43.05], p > 0.001), serum lactic acid (OR = 0.82, 95%CI[0.75, 0.90], p < 0.001), and AST (OR = 1.00, 95% CI[0.99, 1.00], p > 0.001) could be regarded as risk factors for death with 94.0% correct predictions. CONCLUSIONS: The factors affecting the prognosis of EOS in neonates were BW, PPHN, septic shock, heart failure, serum lactic acid, and AST. Timely correction of these modifiable risk factors for death may decrease the mortality of EOS in neonates.