Prevalence of Anemia in Neonates with Sepsis Presenting to a Resource-Limited Neonatal ICU

Background: Anemia is a common and clinically significant condition among neonates with sepsis, particularly in resource-limited settings. Its presence can adversely affect clinical outcomes due to reduced oxygen-carrying capacity, which further exacerbates the pathophysiological stress of sepsis. Factors such as nutritional deficiencies, chronic inflammation, immature erythropoiesis, and frequent blood sampling contribute to the high prevalence of anemia in septic neonates. Understanding its burden in a constrained neonatal ICU setting is essential for improving management protocols and reducing morbidity. Objective: To determine the frequency of anemia among neonates diagnosed with sepsis in a resource-limited Neonatal Intensive Care Unit (NICU) at Women and Children Hospital. Methodology: This descriptive cross-sectional study was conducted in the Neonatal ICU of the Department of Pediatric Medicine, Women and Children Hospital, from 10th November 2023 to 10th April 2024. A total of 110 septic neonates were enrolled using a non-probability consecutive sampling technique, adhering strictly to predefined inclusion and exclusion criteria. Consecutive sampling ensured systematic enrollment of all eligible neonates during the study period. Results: Of the 110 neonates admitted with sepsis, 42% were found to have anemia. The mean age of neonates was 19 ± 8.2 days, with a mean gestational age of 34 ± 5.9 weeks and mean weight of 2.1 ± 1.85 kg. Anemia was significantly associated with neonatal age (p=0.002), birth weight (p=0.01), gestational age (p=0.04), maternal anemia (p=0.02), and maternal educational status (p=0.04). Conclusion: Anemia was prevalent in 42% of septic neonates in this resource-constrained NICU setting. Significant associations with age, low birth weight, prematurity, maternal anemia, and maternal education highlight the need for early risk stratification and targeted interventions to manage and prevent anemia in vulnerable neonatal populations. Keywords: Anemia, Gestational Age, Maternal Health, Neonates, Sepsis.