关键词: 新生儿败血症, 早产儿, 临床特征, 不良结局, 危险因素

Abstract: Objective To analyze the clinical characteristics and risk factors of adverse outcomes of sepsis in premature infants with gestational age < 37 weeks．Methods Clinical data of preterm infants < 37 weeks of gestational age admitted to the Department of Neonatology of the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2023 were collected．According to the timing of sepsis,49 cases with early-onset sepsis（EOS）and 150 cases with late-onset sepsis（LOS）were diagnosed．According to the outcome,90 cases were divided into the adverse outcome group and 109 cases were good outcome group．The clinical characteristics of EOS and LOS were analyzed,and the risk factors of adverse outcomes were analyzed by multivariate logistic regression．Results The gestational age of EOS infants was smaller at birth,the 1 minute Apgar score was lower ,and the incidence of amniotic fluid contamination and premature rupture of membranes ≥18h were higher than those in LOS infants（P<0.05）．The clinical manifestations of sepsis in premature infants were not specific,but the incidence of shock was higher in LOS children（P<0.05）．Preterm infants were more likely to develop gram-negative bacterial infection,congenital heart disease（OR=2.490,P<0.05）,gestational age <30 weeks（OR=4.851,P<0.05）,and birth weight < 1500g（OR=4.169,P<0.05）were identified as significant risk factors for adverse sepsis outcomes in preterm infants．Conclusions The clinical manifestations of septicemia in preterm infants are non-specific,and they are more likely to suffer from gram-negative bacterial infection．The younger the gestational age and lower the birth weight of preterm infants,the higher the risk of adverse outcomes after sepsis．

Key words: neonatal sepsis, premature infants, clinical features, adverse outcome, risk factor