Premature and Low Birth Weight Infants Face Increased Sepsis Risk: Study

Researchers note that infection rates have declined as better infection controls among premature infants see wider use in the U.S., but more could be done

Infants born prematurely, or at a very low weight, face an increased risk of developing late-onset sepsis, which could lead to organ failure and death, according to the findings of new research.

In a study published last month in the medical journal Pediatrics, researchers indicate that premature and low birth weight infants, especially those born before the 27th week of pregnancy, were more likely to acquire sepsis 72 or more hours after birth. The researchers say the risks can be combatted with better infection control and better antiseptic techniques.

Researchers from the Israel Neonatal Network on Very Low Birth Weight Infants reviewed data on approximately 31,612 premature infants, born after 23 weeks of gestational age with very low birth weights, between January 1995 and December 2019. They sought to determine the risk factors associated with developing late-onset sepsis, and the overall rates of infections among the study population.

The study revealed that 7,423 of the 31,612 infants developed late-onset sepsis, 5,889 infants developed at least one late-onset sepsis infection, 1,151 infants developed at least two infection episodes, and 383 infants developed at least three episodes of sepsis 72 hours or more after birth.

Low birth weight infants who were born between 23 and 27 weeks of pregnancy faced an increased risk of developing sepsis later on, according to the findings, and 36.6 percent required resuscitation, compared to infants born after 31 weeks gestational age.

Late-Onset Sepsis Health Risks

Sepsis is a life-threatening condition that occurs when an individual’s immune system has a dangerous response to an infection and starts to damage the body’s tissues and organs. Symptoms of the condition include decreased blood pressure, increased heart rate, fever, confusion, shortness of breath, weakness, and can result in organ failure or death.

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Premature infants fed Similac or Enfamil cow's milk formula faced increased risk of necrotizing enterocolitis (NEC) or wrongful death.


The researchers indicate that late-onset sepsis is a major health care issue among infants born at a very low weight, and is associated with significant mortality rates.

However, the researchers found that mortality rates among premature infants, as well as the overall rate of infections, declined by more than 50 percent over the 25 year study period.

Researchers attribute the dramatic decrease the Israel’s national prevention program initiated in in 2016, which provided education to healthcare staff, improved infection control and aseptic techniques, and changed the definitions of late-onset sepsis.

“The strongest risk factor for late-onset sepsis was gestational age <27 (weeks),” the researchers noted. “Over a 25-year period, the pathogen-specific rates of late-onset sepsis among VLBW infants decreased approximately twofold for gram-positive and gram-negative bacterial infections and sixfold for fungal infections.”


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