Risk factors for neonatal sepsis: an overview

Neonatal sepsis is still a significant cause of mortality and morbidity at the Neonatal Intensive Care Unit (NICU) and an important cause of long hospitalization time, even though it has diminished with the improvement of neonatal care. The aim of this study was to systematically review data on the risk factors for neonatal sepsis, so that the incidence of neonatal sepsis can be minimized. A PubMed literature search for all relevant studies from 1999 to 2019 was conducted and after a first analysis based on titles and abstracts and a second analysis based on the full texts, a total of 35 articles were selected to review. Based on the evidence extracted from these articles, the risk factors for neonatal sepsis can be divided into three categories: maternal factors, neonatal factors and factors associated with the NICU. Thus, the identified maternal risk factors were premature rupture of membranes and maternal infection. In terms of neonatal risk factors, prematurity, low birth weight, low Apgar score, meconium-stained amniotic fluid, birth asphyxia, not crying immediately after birth and need for resuscitation were the primary risk factors identified. Regarding the NICU, the central venous catheter was the most isolated risk factor, both its use and duration, followed by mechanical ventilation and parenteral nutrition. However, some variable results were inconsistent, which reinforces the need for further multicenter studies to evaluate these risk factors in order to understand their association with neonatal sepsis, so that preventive measures can be implemented.