湖北省住院新生儿不同胎龄早发型败血症的特征分析OA

Objective To analyze the perinatal high-risk factors,clinical features,pathogens,treatment,and outcomes of early-onset sepsis(EOS)in hospitalized neonates of different gestational ages(GA),providing guidance for clinical identification and management.Methods A multicenter retrospective cohort study was conducted among neonates diagnosed with EOS and admitted to the NICUs of 11 hospitals in Hubei Province from January 2019 to December 2023.Neonates were divided into the GA≥35 weeks group and the GA<35 weeks group.A comparative analysis of clinical characteristics and outcomes between the two groups was performed.Results A total of 674 neonates were diagnosed with EOS,accounting for 2.1%(674/32095)of all hospitalized neonates during the study period.EOS incidence was 0.48%(674/140416 live births).Of 674 cases,249(36.94%)were GA≥35 weeks and 425(63.06%)were GA<35 weeks.In the GA≥35 weeks group,there was a higher prevalence of maternal gestational diabetes,meconium-stained or foul amniotic fluid,fetal distress,and uterine tenderness.Pathological jaundice,fever,and convulsions were more frequent presentations.Additionally,the incidence of complications such as pulmonary arterial hypertension and septic arthritis was also higher.Moreover,Group B Streptococcus and Klebsiella pneumoniae were the predominant pathogens in this group(χ2 values ranged from 3.494 to 49.341,P<0.05).While in the GA<35 weeks group,there was a higher rate of prolonged rupture of membranes≥18 hours,cervical cerclage,and prenatal antibiotic exposure.Respiratory or circulatory abnormalities,hypothermia,sclerema,bleeding,or purpura were more frequent presentations.The incidences of pulmonary hemorrhage and necrotizing enterocolitis were significantly higher in this group.The differences between the two groups were statistically significant(χ2 values ranged from 3.945 to 61.285,P<0.05).Multivariate logistic regression analysis showed that prolonged rupture of membranes≥18 hours,cervical cerclage,and prenatal antibiotic use were independent risk factors for EOS in the GA<35 weeks group(OR values were 4.18,7.69 and 3.45 respectively,P<0.05).Conclusion The incidence of EOS among hospitalized neonates in Hubei Province was relatively high.Prolonged rupture of membranes≥18 hours,cervical cerclage,and prenatal antibiotic exposure were significant risk factors for EOS in the GA<35 weeks group.Prenatal screening and treatment are of important clinical significance.