Hubungan Usia Gestasi dan Durasi Perawatan NICU dengan Kejadian Sepsis Neonatus Awitan Lambat di RSUP Haji Adam Malik Medan Periode Januari 2022-Juni 2025

Abstract

Introduction: According to the 2023 Indonesian health profile, sepsis is the fourth leading cause of death among neonates, infants, and toddlers. Late-onset neonatal sepsis refers to sepsis occurring in neonates older than seven days, typically resulting from nosocomial infection. The difficulty in diagnosing late-onset sepsis due to atypical symptoms makes it necessary to diagnose based on risk factors of gestational age and duration of NICU care. Objectives: identify the characteristics of infants with confirmed late-onset sepsis and to examine the association between gestational age, duration of NICU care, and the incidence of late-onset neonatal sepsis. Methods: A cross-sectional study was conducted using medical records from the perinatology ward of Haji Adam Malik General Hospital, Medan, between January 2022 and June 2025. Total sampling was employed, including neonates older than seven days with sepsis confirmed by positive blood cultures. Univariate and bivariate analyses were performed using SPSS by applying the chi-square test. Results: Chi-square test showed no relationship between gestational age and the incidence of late-onset sepsis (p=0.682) but there was a relationship between the duration of NICU care and the incidence of late-onset sepsis (p=0.014) Conclusion: From a total of 63 neonates suspected of late-onset sepsis, there were 40 (63.5%) neonates proven to have late-onset sepsis through positive blood culture. No relationship found between gestational age and the incidence of late-onset sepsis, but there was a relationship between the duration of NICU care and the incidence of late-onset sepsis. Infants with late-onset sepsis were predominantly male, term gestational age, normal birth weight, maternal risk factors for premature rupture of membranes, birth in the hospital by c-section, duration of NICU care ≥14 days, using nasal cannula, CVC, and most of the babies survived.