Incidence and Risk Factors of Early-onset Sepsis among Preterm Infants in a Teaching Hospital: A Retrospective Cohort Study

Introduction: Early-onset sepsis (EOS) is associated with a high risk of mortality and morbidity, which are increased in preterm infants. We aim to assess the incidence and factors associated with increased risk of EOS among preterm infants. Methods: We conducted a retrospective cohort study at King Abdulaziz University Hospital, a tertiary and teaching hospital in Jeddah city. We included preterm infants <37 weeks of gestational age (GA) who were admitted to the neonatal intensive care unit. Those with congenital anomalies were excluded from the study. Results: We included 335 preterm infants, out of which 21 (6.3%) were diagnosed with EOS. Preterm infants with EOS had significantly lower GA ( P < 0.001), birth weight ( P = 0.024), and APGAR scores at 1 ( P = 0.024) or 5 min ( P = 0.007). More preterm infants with EOS were born outside the hospital ( P < 0.029) and had significantly higher C-reactive protein ( P = 0.016). Mortality was significantly higher in preterm infants with EOS compared to those without (42.9% vs. 7.3%, P < 0.001). Our multivariate regression analyses showed that decreased GA ( P = 0.006) and delivery outside the hospital ( P = 0.011) were associated with an increased risk of EOS in preterm infants. Conclusion: We identified risk factors that are significantly associated with EOS in preterm infants and should be considered to improve neonatal outcomes.