Comparative Study of Umbilical Cord Blood Versus Peripheral Venous Blood in  Early-Onset  Neonatal Sepsis in a Tertiary Hospital

Background: Neonatal morbidity and mortality continue to be significantly impacted by early-onset sepsis. Blood culture remains the diagnostic gold standard, but obtaining adequate peripheral blood is challenging in neonates. Objective: To evaluate the diagnostic efficacy of umbilical cord blood in early-onset neonatal sepsis (EONS) compared to peripheral venous blood. Methods: A prospective observational study was conducted on 242 neonates with EONS risk factors. Cord blood and peripheral blood were simultaneously collected post-delivery for culture and CRP analysis. Diagnostic accuracy, sensitivity, specificity, and correlation with clinical sepsis were calculated. Results: Among the 242 neonates, 56.6% were male and 43.4% female. Birth asphyxia (38%) and maternal fever (29.7%) were the most common risk factors. Sepsis screen was positive in 27.2% of neonates. Cord blood culture was positive in 26.8% and peripheral culture in 28.1%. The sensitivity and specificity of cord culture were 73.5% and 90.8%, respectively. CRP at a cutoff of 9 mg/L had 41% sensitivity and 83% specificity. Overall, 87.6% of neonates were discharged, 5.7% died, and 6.6% left against medical advice. Conclusion: Umbilical cord blood serves as a viable alternative for early detection of neonatal sepsis, especially in resource-limited settings where peripheral blood access is challenging.