Early Blood Pressure Changes in Neonatal Sepsis and the Risk of Mortality

Neonatal sepsis is an increasingly common cause of mortality and morbidity in newborns, with hemodynamic abnormalities impacting prognosis. Objectives: To evaluate the relationship between blood pressure levels and in-hospital mortality rate in newborns with sepsis. Methods: The comparative cross-sectional study was conducted for six months from August 2023 to January 2024 at the Department in the Neonatal Intensive Care Unit of Khairpur Medical College to Khairpur Mir’s Medical College Teaching Hospital. The total number of participants was n=300 (n=150 participants per group). Blood pressure was monitored at three different periods: 0-24 hours, 24-48 hours, and 48-72 hours. Data were analyzed using t-test independent, chi-square and multivariable logistic regression to assess the association between blood pressure parameters and in-hospital mortality. Results: Our findings indicated that lower systolic, diastolic, and mean blood pressures at all measured time points were closely linked to higher mortality rates in newborns. At 72 hours, culture-positive infants had a median systolic blood pressure of 64 mmHg, while those with clinical signs had a median of 70 mmHg (p=0.008). Each unit's reduction in blood pressure corresponded to a significant increase in the risk of death. Conclusions: It was concluded that neonates with sepsis had lower mean, diastolic, and systolic blood pressures have a higher mortality rate in hospitals which shows that sepsis with positive culture has a higher risk of severe hemodynamic instability when compared to sepsis with clinical signs.