Neonatal Sepsis in Rural Ghana: A Case Control Study of Risk Factors in a Birth Cohort

Abstract

Neonatal sepsis poses a major challenge to achieving the MDG-4 due to lack of facilities to implement proposed management guidelines. Identifying risk factors of neonatal sepsis will help put strategies in place to prevent sepsis. This prospective case control study investigated risk factors of neonatal sepsis in the Asutifi District a typical rural setting of the Brong Ahafo Region of Ghana. A semi-structured check list was used to collect clinical and demographic data from 196 neonates (96 with sepsis as case and 100 without sepsis as control) and respective mothers. Maternal factors that were significantly associated with neonatal sepsis were foul smelling liquor (p=0.001), meconium stained amniotic fluid (p= 0.000), parity (p=0.000), history of UTI/STI (p=0.002) and maternal age (0.017). Neonatal factors that were significantly associated with sepsis include male sex (p=0.040), preterm (p=0.000), not crying immediately after birth (p=0.001), low birth weight <2500g (p=0.000), APGAR score less than 7 (p=0.000) and resuscitation at birth (p=0.004). Priority attention must be given to neonates and mothers with the aforementioned characteristics during antenatal and postnatal care to prevent sepsis.