Neonatal sepsis and its associated factors among asphyxiated newborns admitted in West Oromia Tertiary Hospitals, Ethiopia

Evidence-based estimates of neonatal sepsis among asphyxiated newborns are critical for monitoring the achievement of newborn survival goals and determining the areas of greatest improvement in the reduction of sepsis-related mortality. However, the magnitude of neonatal sepsis among neonates with prenatal asphyxia has not been studied in Ethiopia. Therefore, the study aimed to investigate the magnitude of neonatal sepsis and its associated factors among asphyxiated newborns at tertiary hospitals in West Oromia. In the period from January 1, 2018, to December 31, 2021 an institutional-based cross-sectional study was conducted among 423 newborns with perinatal asphyxia hospitalized in the neonatal intensive unit of the West Oromia five tertiary hospitals. Data were analyzed using Stata version 14. To find the associated factors, multivariate logistic regression was used. P-values were used to determine which variables had a statistically significant correlation with neonatal sepsis, and odds ratios were used to define the strength and direction of the association. The proportion of neonatal sepsis was 321 or 75.88% (95% CI: 71.79-79.97) among neonates with perinatal asphyxia. Hypoglycemia (AOR: 2.38; 95% CI: 2.09-2.73), hyperbilirubinemia (AOR: 2.33; 95% CI: 2.07-2.65), delay in to enteral feeding initiation for more than 48 h and those who had not yet initiated for enteral feeding (AOR: 5.01; 95% CI: 1.18-21.13) and (AOR: 7.21; 95% CI: 1.38-37.55), respectively, were factors associated with sepsis in newborns suffering prenatal asphyxia. The study revealed a high prevalence of neonatal sepsis in cases of perinatal hypoxia. Therefore, to mitigate the risk of sepsis in asphyxiated newborns, it is preferable to start full enteral feeding as soon as possible. Additionally, patients with hypoglycemia or hyperbilirubinemia should receive priority care.