Work

Role of culture positive vaginal infections in preterm premature rupture of membranes and umbilical cord blood cultures at birth for diagnosing early onset neonatal sepsis at a central Indian tertiary healthcare centre: A prospective observational study

Year: 2026

Type: article

Abstract: Background: Preterm pre-labour rupture of membranes (PPROM) is a major contributor to preterm birth and neonatal morbidity. Ascending genital tract infections play a key role in its pathogenesis and may increase the risk of early-onset neonatal sepsis (EONS). Umbilical cord blood culture (UCBC) has been proposed as an early diagnostic tool for neonatal infection. Objectives: To evaluate the role of culture-positive vaginal infections in PPROM and assess the diagnostic utility of UCBC for EONS. Methods: This prospective observational study was conducted at a tertiary care hospital in Central India over a period of 2.5 years which included 83 women with singleton pregnancies complicated by PPROM (28-37 weeks gestation) and culture-positive vaginal infections at a tertiary healthcare centre in Central India. High vaginal swabs and UCBC samples were subjected to microbiological culture. Maternal characteristics, neonatal outcomes, and diagnostic performance of UCBC were analyzed. Results: The mean maternal age was 28.28 ± 5.65 years, and 53.0% were multigravidas. Escherichia coli (42.2%) and Klebsiella spp. (26.5%) were the predominant vaginal isolates. UCBC was positive in 48.2% of neonates. Neonatal sepsis occurred in 50.6% of cases, while 71.1% required NICU admission. Low birth weight and very low birth weight were observed in 59.0% and 19.3% of neonates, respectively. Neonatal sepsis was significantly associated with low birth weight (?²=14.031, p=0.001) and UCBC positivity (?²=32.158, p<0.001). UCBC demonstrated a sensitivity of 76.2%, specificity of 87.8%, positive predictive value of 85.7%, negative predictive value of 78.9%, and accuracy of 82.1% for diagnosing EONS. Conclusion: Gram-negative vaginal infections, predominantly E. coli and Klebsiella spp., were common in PPROM. UCBC showed good diagnostic accuracy and a strong association with neonatal sepsis, supporting its role as a useful adjunct for early diagnosis of EONS in pregnancies complicated by PPROM.

Source: International Journal of Clinical Obstetrics and Gynaecology

DOI: 10.33545/gynae.2026.v10.i4m.2604

Authors: Manjushree Waikar, Himanshi Gajbhiye, Mansi Shrigiriwar

Institution: Government Medical College

Language: English

Topic: Neonatal and Maternal Infections

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

OpenAlex ID: W7171826701