Neonatal sepsis through the prism of cesarean section
Background. Neonatal sepsis is an urgent problem in neonatal practice, especially in middle- and low-income countries, and is an important factor of morbidity and mortality. At the same time, the question of the dependence of neonatal sepsis on the method of delivery remains controversial. The purpo...
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Zaslavsky O.Yu.
2025-05-01
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| Online Access: | https://childshealth.zaslavsky.com.ua/index.php/journal/article/view/1829 |
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| author | O.K. Koloskova O.K. Teslitskyi N.M. Kretsu S.I. Tarnavska O.V. Vlasova L.V. Kolyubakina |
| author_facet | O.K. Koloskova O.K. Teslitskyi N.M. Kretsu S.I. Tarnavska O.V. Vlasova L.V. Kolyubakina |
| author_sort | O.K. Koloskova |
| collection | DOAJ |
| description | Background. Neonatal sepsis is an urgent problem in neonatal practice, especially in middle- and low-income countries, and is an important factor of morbidity and mortality. At the same time, the question of the dependence of neonatal sepsis on the method of delivery remains controversial. The purpose was to analyze the clinical and paraclinical features of neonatal sepsis depending on the method of delivery. Materials and methods. A comprehensive examination of 87 newborns with a verified diagnosis of neonatal sepsis was performed. Depending on the method of delivery, they were divided into two clinical groups. Group I included 37 infants (gestational age 34.20 ± 0.59 weeks) born by cesarean section; 50 children (gestational age 36.10 ± 0.51 weeks) born naturally formed group II. All children underwent a comprehensive general clinical examination, as well as a study of the acid-base homeostasis and oxygen status of the blood. Results. Our studies have shown that the dynamics of adaptation to extrauterine conditions was significantly worse in children born by cesarean section, which was also reflected in the increased need for primary resuscitation immediately after birth compared to infants born vaginally (odds ratio (OR) 2.55 (95% confidence interval (CI): 1.44–4.52), relative risk (RR) 1.61 (95% CI: 1.23–2.11), attributable risk 23 %). Although we did not find a significant difference in the severity of multiple organ dysfunction manifestations and the systemic distribution of its severity, patients in group I differed from newborns in group II by the prevalence of signs of cardiovascular dysfunction and hematologic disorders in the form of increased thrombocytopenia. Instead, the most profound infectious and inflammatory lesions in group II were represented by respiratory distress. Studies of the acid-base homeostasis and oxygen status of the blood showed a more severe condition of newborns in group I that is due to the presence of markers of respiratory (RR 1.4 (95% CI: 0.9–2.1), OR 1.9 (95% CI: 1.0–3.6)) and metabolic acidosis (RR 2.0 (95% CI: 0.9–4.2), OR 6.8 (95% CI: 2.9–15.8)), and required more frequent primary resuscitation. Conclusions. Infants born by cesarean section have metabolic (OR 6.8) and respiratory (OR 1.9) acidosis, lower respiratory indices, which reflects a greater depth of hypoxemia, as well as a significantly lower Apgar score, and the need for primary resuscitation increased by 2.55 times. |
| format | Article |
| id | doaj-art-98957d3c54da4d65bbe72df0c0c433c7 |
| institution | DOAJ |
| issn | 2224-0551 2307-1168 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Zaslavsky O.Yu. |
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| series | Zdorovʹe Rebenka |
| spelling | doaj-art-98957d3c54da4d65bbe72df0c0c433c72025-08-20T02:48:49ZengZaslavsky O.Yu.Zdorovʹe Rebenka2224-05512307-11682025-05-0120319720310.22141/2224-0551.20.3.2025.18291829Neonatal sepsis through the prism of cesarean sectionO.K. Koloskova0https://orcid.org/0000-0002-8878-7041O.K. Teslitskyi1https://orcid.org/0009-0006-7004-5249N.M. Kretsu2https://orcid.org/0000-0003-0241-0700S.I. Tarnavska3https://orcid.org/0000-0003-1046-8996O.V. Vlasova4https://orcid.org/0000-0003-4253-0731L.V. Kolyubakina5https://orcid.org/0000-0002-6735-5602Bukovinian State Medical University, Chernivtsi, UkraineBukovinian State Medical University, Chernivtsi, UkraineBukovinian State Medical University, Chernivtsi, UkraineBukovinian State Medical University, Chernivtsi, UkraineBukovinian State Medical University, Chernivtsi, UkraineBukovinian State Medical University, Chernivtsi, UkraineBackground. Neonatal sepsis is an urgent problem in neonatal practice, especially in middle- and low-income countries, and is an important factor of morbidity and mortality. At the same time, the question of the dependence of neonatal sepsis on the method of delivery remains controversial. The purpose was to analyze the clinical and paraclinical features of neonatal sepsis depending on the method of delivery. Materials and methods. A comprehensive examination of 87 newborns with a verified diagnosis of neonatal sepsis was performed. Depending on the method of delivery, they were divided into two clinical groups. Group I included 37 infants (gestational age 34.20 ± 0.59 weeks) born by cesarean section; 50 children (gestational age 36.10 ± 0.51 weeks) born naturally formed group II. All children underwent a comprehensive general clinical examination, as well as a study of the acid-base homeostasis and oxygen status of the blood. Results. Our studies have shown that the dynamics of adaptation to extrauterine conditions was significantly worse in children born by cesarean section, which was also reflected in the increased need for primary resuscitation immediately after birth compared to infants born vaginally (odds ratio (OR) 2.55 (95% confidence interval (CI): 1.44–4.52), relative risk (RR) 1.61 (95% CI: 1.23–2.11), attributable risk 23 %). Although we did not find a significant difference in the severity of multiple organ dysfunction manifestations and the systemic distribution of its severity, patients in group I differed from newborns in group II by the prevalence of signs of cardiovascular dysfunction and hematologic disorders in the form of increased thrombocytopenia. Instead, the most profound infectious and inflammatory lesions in group II were represented by respiratory distress. Studies of the acid-base homeostasis and oxygen status of the blood showed a more severe condition of newborns in group I that is due to the presence of markers of respiratory (RR 1.4 (95% CI: 0.9–2.1), OR 1.9 (95% CI: 1.0–3.6)) and metabolic acidosis (RR 2.0 (95% CI: 0.9–4.2), OR 6.8 (95% CI: 2.9–15.8)), and required more frequent primary resuscitation. Conclusions. Infants born by cesarean section have metabolic (OR 6.8) and respiratory (OR 1.9) acidosis, lower respiratory indices, which reflects a greater depth of hypoxemia, as well as a significantly lower Apgar score, and the need for primary resuscitation increased by 2.55 times.https://childshealth.zaslavsky.com.ua/index.php/journal/article/view/1829newbornsgestational agecesarean sectioncomplicated maternal historyrespiratory distress |
| spellingShingle | O.K. Koloskova O.K. Teslitskyi N.M. Kretsu S.I. Tarnavska O.V. Vlasova L.V. Kolyubakina Neonatal sepsis through the prism of cesarean section Zdorovʹe Rebenka newborns gestational age cesarean section complicated maternal history respiratory distress |
| title | Neonatal sepsis through the prism of cesarean section |
| title_full | Neonatal sepsis through the prism of cesarean section |
| title_fullStr | Neonatal sepsis through the prism of cesarean section |
| title_full_unstemmed | Neonatal sepsis through the prism of cesarean section |
| title_short | Neonatal sepsis through the prism of cesarean section |
| title_sort | neonatal sepsis through the prism of cesarean section |
| topic | newborns gestational age cesarean section complicated maternal history respiratory distress |
| url | https://childshealth.zaslavsky.com.ua/index.php/journal/article/view/1829 |
| work_keys_str_mv | AT okkoloskova neonatalsepsisthroughtheprismofcesareansection AT okteslitskyi neonatalsepsisthroughtheprismofcesareansection AT nmkretsu neonatalsepsisthroughtheprismofcesareansection AT sitarnavska neonatalsepsisthroughtheprismofcesareansection AT ovvlasova neonatalsepsisthroughtheprismofcesareansection AT lvkolyubakina neonatalsepsisthroughtheprismofcesareansection |