Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.111423
Revised: July 9, 2025
Accepted: October 21, 2025
Published online: March 9, 2026
Processing time: 250 Days and 13.9 Hours
Neonatal sepsis continues to remain a serious threat, with multiple maternal and neonatal risk factors. Understanding these determinants will empower clinicians in comparable settings to apply targeted interventions, ultimately reducing new
To assess maternal and infant risk factors, the aim is to develop evidence-based strategies for preventing neonatal sepsis.
A total of 453 neonates and their mothers were enrolled, of which 146 were cases. Clinical, demographic, and obstetric data were analyzed including maternal in
Male sex (adjusted odd ratio [AOR] = 1.9; 95% confidence interval [CI]: 1.03-3.5), forceps-assisted vaginal delivery (AOR = 3.4; 95%CI: 1.1-14.9), fewer than four antenatal care visits (AOR = 2.9; 95%CI: 1.4-6.5), prolonged labor > 24 hours (AOR = 6.2; 95%CI: 2.8-17), rupture of membranes > 18 hours (AOR = 3.0; 95%CI: 1.6-6.8), and maternal urinary tract infection (AOR = 3.5; 95%CI: 2.4-29.4) significantly increased neonatal sepsis risk. Unclean vaginal examinations (AOR = 4.2; 95%CI: 1.6-11) and foul-smelling amniotic fluid (AOR = 10.3; 95%CI: 1.9-56.4) were among the strongest risk factors. Among neonatal factors prematurity (AOR = 4.3; 95%CI: 2.8-6.6), low birth weight ≤ 1500 g (AOR = 3.6; 95%CI: 2.2-5.7), birth asphyxia (AOR = 4.3; 95%CI: 2.4-7.6), and small-for-gestational-age status (AOR = 2.1; 95%CI: 1.1-4) were significant predictors. Respiratory support showed a strong correlation, with surfactant administration (AOR = 9.7; 95%CI: 4.1-22.9), continuous positive airway pressure) (AOR = 15.4; 95%CI: 9.4-25.1), and invasive ventilation (AOR = 53; 95%CI: 12.7-89) as the highest risk factors. Extended newborn intensive care unit stays (> 7 days: AOR = 38.9; > 15 days: AOR = 30) further elevated the likelihood of sepsis, likely due to nosocomial exposure.
The findings highlight the importance of enhanced prenatal care, timely labor management, strict hygiene protocols, and focused neonatal monitoring to reduce neonatal sepsis incidence. Addressing modifiable risk factors, including maternal infections and respiratory interventions, could significantly improve neonatal outcomes in resource-limited settings.
Core Tip: Neonatal sepsis in our study was strongly associated with several modifiable maternal and intrapartum factors, namely insufficient antenatal visits, prolonged labor or membrane rupture, forceps delivery, non-sterile vaginal examinations, and maternal urinary tract infections. Compounded by neonatal vulnerabilities including prematurity, very low birth weight, small-for-gestational-age, birth asphyxia, advanced respiratory support need, prolonged newborn intensive care unit (NICU) stays, with the latter reflecting greater exposure to nosocomial pathogens. Targeted, tiered interventions spanning antenatal care through delivery and the NICU, emphasizing risk stratification, aseptic practices, early surveillance, and timely prophylaxis can sharply reduce sepsis rates and enhance newborn survival.