J Pediatr Infect Dis 2021; 16(06): 269-277
DOI: 10.1055/s-0041-1732472
Original Article

Risk Factors for Neonatal Sepsis in Secondary and Tertiary Care Hospitals of a District in Sri Lanka: A Case–Control Study

Chintha Jayasinghe
1   Ministry of Health, Sri Lanka
2   Department of Public Health, Faculty of Medicine, University of Kelaniya, Sri Lanka
› Institutsangaben
Funding None.


Objective The aim of this study was to determine the risk factors for neonatal sepsis.

Methods A case–control study was performed in secondary and tertiary care hospitals of a district in Sri Lanka. Neonates who diagnosed with sepsis based on clinical criteria or culture positivity were taken as the case group (n = 240) and neonates born during the same period who had not been diagnosed with sepsis were taken as the control group (n = 240). The controls were recruited from the community. The study instruments were, pretested interviewer administered questionnaire, a check list and record sheets. Multiple logistic regression analysis was performed. The results were expressed as odds ratios (OR) with the 95% confidence intervals (CI).

Results The independent risk factors for neonatal sepsis were history of abortions, still birth, and early neonatal deaths (OR: 6.78; 95% CI: 3.2–14.3), registration of pregnancy after 8 weeks of gestation (OR: 1.91; 95% CI: 1.07–3.4), total antenatal clinic visits ≤4 (OR: 7.18; 95% CI: 2.1–24.5), history of maternal fever prior to the week of delivery (OR: 2.74; 95% CI: 1.25–6.0) leaking amniotic fluid >18 hours (OR: 10.0; 95% CI: 2.1–47.4), performed >3 vaginal examinations before delivery (OR: 3.28; 95% CI: 2.1–24.5), meconium stained amniotic fluid (OR: 10.57; 95% CI: 3.7–29.7), mode of delivery by cesarean section, forceps or vacuum (OR: 2.33; 95% CI: 1.4–3.9), time of birth of the neonate being during on-call hours (OR: 2.12; 95% CI: 1.3–3.5), being a male baby (OR: 1.74; 95% CI: 1.1–2.8), and birth weight <2,500 g (OR: 5.17; 95% CI: 2.8–9.6) of neonates.

Conclusion Most of the identified risk factors for neonatal sepsis were modifiable. Stringent implementation of guidelines and protocols would prevent neonatal sepsis.


The Ethics Review Committee of the Faculty of Medicine, University of Kelaniya granted ethical clearance. Informed written consent was obtained from the mothers prior to data collection. Permissions were obtained from the Regional Director of Health Services of the Gampaha District.

Authors' Contributions

C.J. participated in the design of the study, coordinated data collection, performed the statistical analysis, and helped to draft the manuscript. C.A. participated in the design of the study, performed the statistical analysis, interpreted the data, and drafted the first version of the manuscript. Both authors read and approved the final manuscript.


Eingereicht: 04. Dezember 2020

Angenommen: 14. Juni 2021

Artikel online veröffentlicht:
29. Juli 2021

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