Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more

Objective: To analyze the incidence, complications, and hospital discharge status in newborns with >= 35 weeks of gestational age with early neonatal sepsis. Methods: This is a cross-sectional, retrospective study. Cases of early-onset sepsis registered from January 2016 to December 2019 in neonates with gestational age of 35 weeks or more were reviewed in a level III neonatal unit. The diagnoses were performed based on the criteria by the Brazilian Health Regulatory Agency (Anvisa), and the episodes were classified according to microbiological classification and site of infection. The following complications were evaluated: shock, coagulation disorders, and sequelae of the central nervous system. The conditions at hospital discharge were also assessed. The collected data were analyzed with the descriptive analysis. Results: In the period, early neonatal sepsis occurred in 46 newborns, corresponding to 1.8% of all newborns admitted to the neonatal unit, with a prevalence of 4/1,000 live births. Culture confirmed sepsis ocurred in three patients (0.3/1,000 live births), with the following agents: S. pneumoniae, S. epidermidis and S. agalactiae. As to site of infection, there were 35 cases of primary bloodstream infection, seven cases of pneumonia and four cases of meningitis. Most patients (78.3%) had at least one risk factor for sepsis, and all were symptomatic at admission. There were no deaths. Complications occurred in 28.2% of the cases, especially shock (10 cases - 21.7%). Conclusions: The prevalence of proven early neonatal sepsis was low. Despite the common occurrence of complications, there were no deaths.