Risk factors for neonatal sepsis in the intensive care unit: a scoping review

Paiva, Emilly Fátima Garcia de; Caldeira, Natalia Maria Vieira Pereira; Carbogim, Fábio da Costa; Rodrigues, Flávia Cristina; Prado, Roberta Teixeira; Santos, Kelli Borges dos; Dutra, Herica Silva; Alvim, André Luiz Silva

doi:10.1590/1983-1447.2026.20250290.en

person Emilly Fátima Garcia de Paiva

Conceptualization · Data curation · Formal analysis · Investigation · Methodology · Project administration · Writing-original draft · Writing-review & editing

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0009-0002-1211-7372

person Natalia Maria Vieira Pereira Caldeira

Writing-original draft · Writing-review & editing

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0000-0002-4231-7116

person Fábio da Costa Carbogim

Writing-original draft · Writing-review & editing · Validation

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0000-0003-2065-5998

person Flávia Cristina Rodrigues

Writing-original draft · Writing-review & editing

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0000-0003-2063-8506

person Roberta Teixeira Prado

Writing-original draft · Writing-review & editing

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0000-0001-8738-2248

person Kelli Borges dos Santos

Writing-original draft · Writing-review & editing

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0000-0001-8423-9147

person Herica Silva Dutra

Writing-original draft · Writing-review & editing

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0000-0003-2338-3043

person André Luiz Silva Alvim

Conceptualization · Data curation · Formal analysis · Investigation · Methodology · Resources · Supervision · Visualization · Validation · Writing-original draft · Writing-review & editing

school Universidade Federal de Juiz de Fora (UFJF). Programa de Pós-Graduação em Enfermagem. Juiz de Fora, Minas Gerais, Brasil.

0000-0001-6119-6762

personCorresponding author: André Luiz Silva Alvim E-mail:
andrealvim1@ufjf.br

The authors declare that there is no conflict of interest.

Associate editor:

Carlise Rigon Dalla Nora

Editor-in-chief:

João Lucas Campos de Oliveira

Information source	Search conducted	No. of publications
PUBMED	((((“risk factors”[MeSH Terms] OR (“risk”[All Fields] AND “factors”[All Fields]) OR “risk factors”[All Fields]) AND (“sepsis”[MeSH Terms] OR “sepsis”[All Fields])) OR (“neonatal sepsis”[MeSH Terms] OR (“neonatal”[All Fields] AND “sepsis”[All Fields]) OR “neonatal sepsis”[All Fields])) AND (“intensive care units”[MeSH Terms] OR (“intensive”[All Fields] AND “care”[All Fields] AND “units”[All Fields]) OR “intensive care units”[All Fields]) AND (“infant, premature”[MeSH Terms] OR (“infant”[All Fields] AND “premature”[All Fields]) OR “premature infant”[All Fields] OR “infant premature”[All Fields]))	99
Scopus	(risk AND factors AND sepsis OR neonatal AND sepsis AND intensive AND care AND units AND disease)	84
EMBASE		115
LILACS*	Risk Factors AND Sepsis OR Neonatal Sepsis AND Intensive Care Unit	66
BDENF		20
WPRO		70
SciELO		12
Google Scholar		64
IBECS	Sepsis AND Intensive Care Unit	57
Cochrane Library	(risk AND factors AND sepsis OR neonatal) AND sepsis AND intensive AND care AND units AND infant, AND premature in Title Abstract Keyword	08
OATD	Risk Factors AND Sepsis OR Neonatal Sepsis AND Intensive Care Units	04

Author (Year)	Title	Country/ Language	Study Type	Participants/ sample
Varão et al. (2025)¹⁵	Risk factors associated with neonatal sepsis in the Brazilian Unified Health System: a systematic literature review	Brazil/ Portuguese	Systematic Review	Scientific articles (n=5)
Baheru et al. (2024)¹⁶	Magnitude of neonatal sepsis and its associated factors among neonates admitted to the neonatal intensive care unit in Hawassa Comprehensive Specialized Hospital, Sidama Regional State, Ethiopia, 2020	Ethiopia/ English	Cross-sectional	Neonates (n=287)
Lamy-Filho et al. (2024)¹⁷	Skin-to-skin contact and late-onset sepsis in newborns weighing up to 1,800g: a cohort study	Brazil/ English	Multicenter cohort	Neonates (n=405)
Lima et al. (2024)¹⁸	Early-onset sepsis in preterm infants in Neonatal Intensive Care Units	Brazil/ Portuguese	Cohort study	Preterm neonates (n=268)
Brito et al. (2024)¹⁹	Factors associated with deaths due to early and late neonatal sepsis in a neonatal intensive care unit	Brazil/ Portuguese	Quantitative, descriptive, documentary study	Infant death investigation records (n=119)
Boff et al. (2024)²⁰	Risk factors for neonatal sepsis in the intensive care unit	Brazil/ Portuguese	Integrative Review	Scientific articles (n=6)
Cavichion et al. (2024)²¹	Neonatal sepsis: Clinical characteristics and risk factors in a Neonatal Intensive Care Unit	Brazil/ Portuguese	Retrospective study	Medical records (n=490)
Ganfure et al. (2023)²²	Sepsis Risk Factors in Neonatal Intensive Care Units of Public Hospitals in Southeast Ethiopia, 2020: A Retrospective Unmatched Case-Control Study	Ethiopia/ English	Case-control	Neonates (n=291)
Catapani et al. (2023)²³	Overview of neonatal sepsis in a Neonatal Intensive Care Unit: an integrative review	Brazil/ Portuguese	Narrative Review	Scientific articles (n/a)
Lima et al. (2023)²⁴	Risk factors associated with the development of neonatal sepsis in the Intensive Care Unit	Brazil/ Portuguese	Integrative Review	Scientific articles (n=10)
Souza et al. (2023)²⁵	Risk factors related to the development of neonatal sepsis: an integrative review	Brazil/ Portuguese	Integrative Review	Scientific articles (n=16)
Lima et al. (2023)²⁶	Neonatal sepsis: Risk factors and nursing care practices	Brazil/ Portuguese	Integrative Review	Scientific articles (n=15)
Bekele et al. (2022)²⁷	Predictors of mortality among neonates hospitalized with neonatal sepsis: a case control study from southern Ethiopia	Ethiopia/ English	Case-control	Neonates (n=219)
Gebreheat et al. (2022)²⁸	Predictors of respiratory distress syndrome, sepsis and mortality among preterm neonates admitted to neonatal intensive care unit in northern Ethiopia	Ethiopia/ English	Cross-sectional	Preterm neonates (n=816)
Malaquias et al. (2022)²⁹	Risk factors for late-onset neonatal sepsis: a narrative review	Brazil/ Portuguese	Narrative Review	Scientific articles (n/a)
Oliveira et al. (2022)³⁰	Characterization of risk factors and occurrence of death in newborns diagnosed with neonatal sepsis in a Neonatal Intensive Care Unit	Brazil/ Portuguese	Cross-sectional study	Neonates (n=410)
Travassos et al. (2022)³¹	Risk factors associated with the occurrence of sepsis in patients in Intensive Care Units	Brazil/ Portuguese	Systematic Review	Scientific articles (n=6)
Denicol et al. (2022)³²	Early-onset sepsis as a risk factor for peri-intraventricular hemorrhage in preterm infants in a tertiary neonatal ICU: a retrospective cohort	Brazil/ Portuguese	Retrospective cohort	Neonates (n=487)
Cardoso et al. (2021)³³	Early neonatal sepsis: Clinical and epidemiological profile of patients included in a neonatal sepsis protocol	Brazil/ Portuguese	Cross-sectional study	Neonatal medical records (n=433)
Hewamalage et al. (2019)³⁴	Nurses’ knowledge on neonatal sepsis in a tertiary care hospital in Sri Lanka	Sri Lanka/ English	Descriptive cross-sectional study	Nurses (n=81)
Alemu et al. (2019)³⁵	Determinants of neonatal sepsis among neonates in the northwest part of Ethiopia: case-control study	Ethiopia/ English	Case-control	Neonates (n=246)
Reyes et al. (2019)³⁶	Prevalence of extended-spectrum beta-lactamases in enterobacteria of neonatal sepsis and associated factors	Guadalajara/ Spanish	Prospective cohort	Neonates (n=1501)
Barbosa et al. (2019)³⁷	Risk factors for the development of neonatal sepsis in neonatal intensive care units in hospitals in Campos Gerais	Brazil/ Portuguese	Retrospective cohort	Medical records (n=520)
Dortas et al. (2019)³⁸	Risk factors associated with neonatal sepsis: a review article	Brazil/ Portuguese	Literature Review	Scientific articles (n=14)

Category	Risk Factors
Maternal and obstetric factors¹⁵^,¹⁸^-²⁰^,²²^-²⁶^,²⁹^-³⁰^,³²^-³⁵^,³⁷^-³⁸	Urinary infection; Chorioamnionitis; Maternal fever/pyrexia; Premature or prolonged rupture of membranes; Colonization by Group B Streptococcus agalactiae; Sexually transmitted infections; Preeclampsia/eclampsia; Inadequate prenatal care; Foul-smelling or meconium-stained amniotic fluid; Preterm labor; Mode of delivery.
Neonatal factors¹⁵^,¹⁷^-²⁵^,²⁷^-³⁰^,³²^-³³^,³⁶^-³⁸	Prematurity; Low birth weight; Low Apgar score; Male sex; Birth asphyxia; Immunological immaturity; Seizures; Respiratory distress; Extreme gestational age.
Care-related and NICU factors¹⁶^,¹⁹^-²¹^,²³^-²⁶^,²⁸^-³²^,³⁴^,³⁷^-³⁸	Use of invasive devices (mechanical ventilation, PICC, central venous catheter); Cardiopulmonary resuscitation; Parenteral nutrition; Invasive monitoring; Prolonged use of antibiotics; Prolonged hospitalization; Use of incubator; Frequent handling of the newborn; Failure in hand hygiene.
Factors related to feeding and early care¹⁵^,²⁴^-²⁵^,³⁰^,³²^,³⁷	Delay in initiation of enteral feeding; Inadequate or delayed breastfeeding; Inability to breastfeed.

[TFN1] *Terms, descriptors and keywords in English, Portuguese and Spanish were considered.

Risk factors for neonatal sepsis in the intensive care unit: a scoping review

Factores de riesgo para la sepsis neonatal en la unidad de cuidados intensivos: una revisión de alcance