Risk factors and prognosis for neonatal sepsis in southeastern Mexico analysis of a four-year historic cohort follow-up 英文参考文献.docVIP

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Risk factors and prognosis for neonatal sepsis in southeastern Mexico analysis of a four-year historic cohort follow-up 英文参考文献.doc

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Risk factors and prognosis for neonatal sepsis in southeastern Mexico analysis of a four-year historic cohort follow-up 英文参考文献

Lealetal.BMCPregnancyandChildbirth2012,12:48 /1471-2393/12/48 RESEARCH ARTICLE OpenAccess Riskfactorsandprognosisforneonatalsepsisin southeasternMexico:analysisofafour-year historiccohortfollow-up YeldaALeal1*,Joséálvarez-Nemegyei2,JuanRVelázquez3,UlisesRosado-Quiab4,NidiaDiego-Rodríguez5, EtnaPaz-Baeza6andJorgeDávila-Velázquez Abstract Background:Neonatalsepsisisaworldwidepublichealthissueinwhich,dependingonthestudiedpopulation, markedvariationsconcerningitsriskandprognosticfactorshavebeenreported.Theaimofthisstudywasto assessriskandprognosticfactorsforneonatalsepsisprevailingatamedicalunitinsoutheasternMexico.Thus,we usedahistoriccohortdesigntoassesstheassociationbetweenaseriesofneonatesandtheirmothers,inaddition tohospitalevolutionfeaturesandtheriskandprognosisofneonatalsepsis(definedbyPediatricSepsisConsensus [PSC]criteria)in11,790newbornsconsecutivelyadmittedtoaNeonatologyServiceinMérida,Mexico,between 2004and2007. Results:Sepsiswasfoundin514of11,790(4.3%)newborns;387ofthesecaseswerecategorizedasearly-onset (72h)(75.3%)and127,aslate-onset(72h)(24.7%).Afterlogisticregression,riskfactorsforsepsisincludedthe following:lowbirthweight;prematurity;abnormalamnioticfluid;prematuremembranerupture(PMR)at24h; respiratorycomplications,andtherequirementofassistedventilation,O2Inspirationfraction(IF)60%,ora surgicalprocedure.Someofthesefactorsweredifferentiallyassociatedwithearly-orlate-onsetneonatalsepsis.The overallmortalityrateofsepsiswas9.5%.Amarkeddifferenceinthemortalityratewasfoundbetweenearly-and late-onsetsepsis(p0.0001).AfterCoxanalysis,factorsassociatedwithmortalityinnewbornswithsepsis comprisedthefollowing:prematurity;lowbirthweight;lowApgarscore;perinatalasphyxia,andtherequirementof anyinvasivemedicalorsurgicalprocedure. Conclusions:TheincidenceofneonatalsepsisinsoutheasternMexicowas4.3%.Adifferentriskandprognostic profilebetweenearly-andlate-onsetneonatalsepsiswasfound. Keywords:Neonatalsepsis,Early-onsetneonatalsepsis,Late-onsetneonatalsepsis,Riskfactors,Pr