Risk factors for possible serious bacterial infection in a rural cohort of young infants in central India

BMC Public Health

Research Article

Lauren Arlington¹  Patricia L. Hibberd¹  Marie E. Wang²  Amber Prakash³  Archana B. Patel³  Nellie I. Hansen⁴ 

[1] Department of Global Health, Boston University School of Public Health, Boston University, Boston, MA, USA;Division of Infectious Diseases, Department of Medicine, Boston Children’s Hospital, Boston, MA, USA;Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA;Lata Medical Research Foundation, Nagpur, Maharashtra, India;RTI International, Research Triangle Park, NC, USA;

关键词: Cohort;    Possible serious bacterial infection;    Young infant;    India;   

DOI  :  10.1186/s12889-016-3688-3

 received in 2016-06-14, accepted in 2016-09-20,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPossible serious bacterial infection (PBSI) is a major cause of neonatal mortality worldwide. We studied risk factors for PSBI in a large rural population in central India where facility deliveries have increased as a result of a government financial assistance program.MethodsWe studied 37,379 pregnant women and their singleton live born infants with birth weight ≥ 1.5 kg from 20 rural primary health centers around Nagpur, India, using data from the 2010–13 population-based Maternal and Newborn Health Registry supported by NICHD’s Global Network for Women’s and Children’s Health Research. Factors associated with PSBI were identified using multivariable Poisson regression.ResultsTwo thousand one hundred twenty-three infants (6 %) had PSBI. Risk factors for PSBI included nulliparity (RR 1.13, 95 % CI 1.03–1.23), parity > 2 (RR 1.30, 95 % CI 1.07–1.57) compared to parity 1–2, first antenatal care visit in the 2nd/3rd trimester (RR 1.46, 95 % CI 1.08–1.98) compared to 1st trimester, administration of antenatal corticosteroids (RR 2.04, 95 % CI 1.60–2.61), low birth weight (RR 3.10, 95 % CI 2.17–4.42), male sex (RR 1.20, 95 % CI 1.10–1.31) and lack of early initiation of breastfeeding (RR 3.87, 95 % CI 2.69–5.58).ConclusionInfants who are low birth weight, born to mothers who present late to antenatal care or receive antenatal corticosteroids, or born to nulliparous women or those with a parity > 2, could be targeted for interventions before and after delivery to improve early recognition of signs and symptoms of PSBI and prompt referral. There also appears to be a need for a renewed focus on promoting early initiation of breastfeeding following delivery in facilities.Trial registrationThis trial is registered at ClinicalTrials.gov (NCT01073475).

【 授权许可】

CC BY   
© The Author(s). 2016