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BMC Public Health. 2016 Oct 19;16(1):1097.

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

Author information

1
Division of Infectious Diseases, Department of Medicine, Boston Children's Hospital, Boston, MA, USA. marie.wang@childrens.harvard.edu.
2
Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA. marie.wang@childrens.harvard.edu.
3
Lata Medical Research Foundation, Nagpur, Maharashtra, India.
4
RTI International, Research Triangle Park, NC, USA.
5
Department of Global Health, Boston University School of Public Health, Boston University, Boston, MA, USA.

Abstract

BACKGROUND:

Possible 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.

METHODS:

We 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.

RESULTS:

Two 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).

CONCLUSION:

Infants 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 REGISTRATION:

This trial is registered at ClinicalTrials.gov ( NCT01073475 ).

KEYWORDS:

Cohort; India; Possible serious bacterial infection; Young infant

PMID:
27760543
PMCID:
PMC5070173
DOI:
10.1186/s12889-016-3688-3
[Indexed for MEDLINE]
Free PMC Article

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