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Risk factors of neonatal sepsis in India: A systematic review and meta-analysis
BACKGROUND: The incidence of neonatal sepsis in India is the highest in the world. Evidence regarding its risk factors can guide clinical practice and prevention strategies. OBJECTIVE: To review, assess and synthesize the available literature from India on the risk factors of sepsis among neonates....
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483350/ https://www.ncbi.nlm.nih.gov/pubmed/31022223 http://dx.doi.org/10.1371/journal.pone.0215683 |
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author | Murthy, Shruti Godinho, Myron Anthony Guddattu, Vasudeva Lewis, Leslie Edward Simon Nair, N. Sreekumaran |
author_facet | Murthy, Shruti Godinho, Myron Anthony Guddattu, Vasudeva Lewis, Leslie Edward Simon Nair, N. Sreekumaran |
author_sort | Murthy, Shruti |
collection | PubMed |
description | BACKGROUND: The incidence of neonatal sepsis in India is the highest in the world. Evidence regarding its risk factors can guide clinical practice and prevention strategies. OBJECTIVE: To review, assess and synthesize the available literature from India on the risk factors of sepsis among neonates. METHODOLOGY: A systematic review was conducted. We searched PubMed, CINAHL, Scopus, Web of Science, Popline, IndMed, Indian Science Abstracts and Google Scholar from inception up to March 23, 2018 to identify observational analytical studies reporting on risk factors of laboratory-confirmed neonatal sepsis in India. Two authors independently screened studies (title, abstract and full-text stages), extracted data, and assessed quality. A random-effects meta-analysis was performed as substantial heterogeneity was anticipated. Subgroup and sensitivity analyses were additionally performed. Effect size in our review included odds ratio and standardized mean difference. RESULTS: Fifteen studies were included from 11,009 records, of which nine were prospective in design. Birthweight and gestational age at delivery were the most frequently reported factors. On meta-analyses, it was found that male sex (OR: 1.3, 95% CI: 1.02, 1.68), out born neonates (OR: 5.5, 95% CI: 2.39, 12.49), need for artificial ventilation (OR: 5.61; 95% CI: 8.21, 41.18), gestational age <37 weeks (OR: 2.05; 95% CI:1.40, 2.99) and premature rupture of membranes (OR:11.14, 95% CI: 5.54, 22.38) emerged as risk factors for neonatal sepsis. Included studies scored lowest on exposure assessment and confounding adjustment, which limited comparability. Inadequacy and variation in definitions and methodology affected the quality of included studies and increased heterogeneity. CONCLUSIONS: Male neonates, outborn admissions, need for artificial ventilation, gestational age <37 weeks and premature rupture of membranes are risk factors for sepsis among neonates in India. Robustly designed and reported research is urgently needed to confirm the role of other risk factors of neonatal sepsis in India. |
format | Online Article Text |
id | pubmed-6483350 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-64833502019-05-09 Risk factors of neonatal sepsis in India: A systematic review and meta-analysis Murthy, Shruti Godinho, Myron Anthony Guddattu, Vasudeva Lewis, Leslie Edward Simon Nair, N. Sreekumaran PLoS One Research Article BACKGROUND: The incidence of neonatal sepsis in India is the highest in the world. Evidence regarding its risk factors can guide clinical practice and prevention strategies. OBJECTIVE: To review, assess and synthesize the available literature from India on the risk factors of sepsis among neonates. METHODOLOGY: A systematic review was conducted. We searched PubMed, CINAHL, Scopus, Web of Science, Popline, IndMed, Indian Science Abstracts and Google Scholar from inception up to March 23, 2018 to identify observational analytical studies reporting on risk factors of laboratory-confirmed neonatal sepsis in India. Two authors independently screened studies (title, abstract and full-text stages), extracted data, and assessed quality. A random-effects meta-analysis was performed as substantial heterogeneity was anticipated. Subgroup and sensitivity analyses were additionally performed. Effect size in our review included odds ratio and standardized mean difference. RESULTS: Fifteen studies were included from 11,009 records, of which nine were prospective in design. Birthweight and gestational age at delivery were the most frequently reported factors. On meta-analyses, it was found that male sex (OR: 1.3, 95% CI: 1.02, 1.68), out born neonates (OR: 5.5, 95% CI: 2.39, 12.49), need for artificial ventilation (OR: 5.61; 95% CI: 8.21, 41.18), gestational age <37 weeks (OR: 2.05; 95% CI:1.40, 2.99) and premature rupture of membranes (OR:11.14, 95% CI: 5.54, 22.38) emerged as risk factors for neonatal sepsis. Included studies scored lowest on exposure assessment and confounding adjustment, which limited comparability. Inadequacy and variation in definitions and methodology affected the quality of included studies and increased heterogeneity. CONCLUSIONS: Male neonates, outborn admissions, need for artificial ventilation, gestational age <37 weeks and premature rupture of membranes are risk factors for sepsis among neonates in India. Robustly designed and reported research is urgently needed to confirm the role of other risk factors of neonatal sepsis in India. Public Library of Science 2019-04-25 /pmc/articles/PMC6483350/ /pubmed/31022223 http://dx.doi.org/10.1371/journal.pone.0215683 Text en © 2019 Murthy et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Murthy, Shruti Godinho, Myron Anthony Guddattu, Vasudeva Lewis, Leslie Edward Simon Nair, N. Sreekumaran Risk factors of neonatal sepsis in India: A systematic review and meta-analysis |
title | Risk factors of neonatal sepsis in India: A systematic review and meta-analysis |
title_full | Risk factors of neonatal sepsis in India: A systematic review and meta-analysis |
title_fullStr | Risk factors of neonatal sepsis in India: A systematic review and meta-analysis |
title_full_unstemmed | Risk factors of neonatal sepsis in India: A systematic review and meta-analysis |
title_short | Risk factors of neonatal sepsis in India: A systematic review and meta-analysis |
title_sort | risk factors of neonatal sepsis in india: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483350/ https://www.ncbi.nlm.nih.gov/pubmed/31022223 http://dx.doi.org/10.1371/journal.pone.0215683 |
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