Page 81 - Abstract Book KONIKA 18

Neonatology

O-NEO-001
Risk Factor and Etiology of Sepsis to Prevent Neonatal Death: a Systematic
Review and Meta-Analysis

Naili Nur Sa’adah Nuhriawangsa , Medita Prasetyo 2
1
1
2
Faculty of Medicine , Universitas Sebelas Maret and Departement of Child Health , Faculty of Medicine,

Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia
Abstract
Background Neonatal sepsis remains a leading cause of morbidity and mortality among neonates, especially
in middle and lower-income countries. However, the risk factor identification of neonates at imminent risk
of death is challenging. Objective To review, assess and synthesize the available literature on risk factors
of neonatal sepsis. Methods We conducted an overall search of 4 databases from June, 9 to July, 30, 2021,
accepting PRISMA guidelines to assess each study using the Critical Capability Assessment Program (CASP)
from the Qualitative Research Assessment List. A meta-analysis was performed. Effect size included odds
ratio and standardized mean difference. Results Nine studies were included from 1,338 records. On meta-
analyses, it was found that gestational age <37 weeks (OR 0.48; 95%CI 0.40 to 0.58), premature rupture
of membranes (OR 4.14; 95%CI 2.77 to 6.18), amniotic membrane inflammation (OR 4.79; 95%CI 2.73
to 8.42), maternal age 30-34 years (OR 1.04; 95%CI 0.82 to 1.32), history of UTIs (OR 2.31; 95%CI 1.86
to 2.85), caesarean delivery (OR 0.58; 95%CI 0.49 to 0.69), resuscitation at birth (OR 4.13, 95%CI 3.07,
to 5.57), birth weight ≤2500 gr (OR 4.26; 95%CI 2.57 to 7.09), APGAR score <7 (OR 7.34; 95%CI 5.03,
to 10.71), and NGT insertion (OR 6.86; 95%CI 3.86 to 12.18) emerged as risk factors for neonatal sepsis.
Coagulase-negative staphylococci, Staphylococcus aureus, Klebsiella pneumoniae, Candida spp., Escherichia
coli, Streptococcus agalactiae were common etiology in neonatal sepsis. Conclusion Neonatal sepsis is
still a problem worldwide. Maternal and neonatal related factors were identified for neonatal sepsis to help
decrease neonatal death rate.
Keywords: risk factor; etiology; sepsis neonatal; prevent

O-NEO-002
Oxygen Use during Neonatal Resuscitation:
Evidence from Nationwide Survey of Practice

Hardya Gustada Hikmahrachim , Rinawati Rohsiswatmo , M. Azharry Rully , Distyayu Sukardja 2
2
1
2
1
Faculty of Medicine and Department of Child Health , Universitas Indonesia, Jakarta, Indonesia
2
Abstract
Background Oxygen use at the start of neonatal resuscitation is 21% for term infants and 30% for preterm
infants according to current recommendation. This protocol is important as high fraction of supplemental
oxygen has been identified as cause of retinopathy of prematurity. Objective To investigate appropriate oxygen
use during neonatal resuscitation and its supporting factors in Indonesia. Methods An online questionnaire-
type survey was held in August 2021. This survey was distributed through professional organizations and
health facilities, especially in newborn care unit. Multivariate analysis was conducted to determine the
supporting factors of appropriate oxygen use during resuscitation. Results 2160 respondents from 34 provinces
filled out the survey, consist of pediatrician (27.83%), general practitioner (5.47%), midwives (42.95%), and
nurse (23.75%). Only 51.2% facilities had oxygen blender and 65.8% had neonatal pulse-oximeter. Median
working experience was 7 years (range 6 months-30 years). Only 33.01% used appropriate oxygen, while
48.56% used 100% oxygen during neonatal resuscitation. Supporting factors were NICU availability (aOR
2.19; 95%CI 1.76 to 2.72), had received neonatal resuscitation training (aOR 1.34; 95%CI 1.01 to 1.78), and
routinely assisting high-risk deliveries (aOR 1.14; 95%CI 1.02 to 1.27). Non-supporting factors were rural
area healthcare facilities (aOR 0.64; 95%CI 0.52 to 0.79) and resuscitation led by nurse/midwife (aOR 0.48;
95%CI 0.33 to 0.69) or without leader (aOR 0.52; 95%CI 0.38 to 0.71). Conclusion Facilities and training
are the main factors of appropriate oxygen use during neonatal resuscitation. Multi-stakeholder involvement
is needed to improve this situation.
Keywords: facilities; newborn care; neonatal resuscitation; oxygen supplementation; training

KONIKA XVIII Abstract Book 35