Blood Glucose Abnormalities and Their Association With Mortality Among Neonates With Sepsis: A Prospective Observational Study From a Tertiary Care Center in Central India.

BACKGROUND: Neonatal sepsis remains a leading cause of neonatal morbidity and mortality, particularly in resource-limited settings. Beyond infection itself, metabolic disturbances, such as abnormalities of blood glucose, may influence disease severity and outcome. Data on the prognostic significance of glycemic derangement in septic neonates from Indian tertiary care units remain limited. OBJECTIVE: This study aimed to determine the prevalence of blood glucose abnormalities among neonates with sepsis and to assess their association with in-hospital mortality. MATERIALS AND METHODS: This prospective observational study was conducted over 18 months in the level III NICU of Index Medical College Hospital and Research Centre, Indore, a tertiary care referral center, and included 100 consecutively enrolled neonates with proven, probable, or possible sepsis. Blood glucose was measured within one hour of admission and categorized as hypoglycemia (<40 mg/dL), normoglycemia (40-145 mg/dL), or hyperglycemia (>145 mg/dL). Clinical features, laboratory parameters, microbiological findings, and outcomes were recorded on a predesigned proforma. Analysis was performed using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA); a two-sided p-value <0.05 was considered statistically significant. RESULTS: Early-onset sepsis predominated (88/100, 88.0%). Glycemic abnormalities were present in 28/100 (28.0%) neonates; 17/100 (17.0%) had hypoglycemia, and 11/100 (11.0%) had hyperglycemia. Overall mortality was 11/100 (11.0%). Mortality was significantly higher among hypoglycemic (5/17, 29.4%) and hyperglycemic (3/11, 27.3%) neonates than among normoglycemic neonates (3/72, 4.2%). Respiratory distress was the commonest presentation (48/100, 48.0%), and blood cultures were positive in 18/100 (18.0%) neonates, with Staphylococcus aureus isolated in 9/100 (9.0%). CONCLUSIONS: Glycemic derangements are common in neonatal sepsis and are significantly associated with increased in-hospital mortality. Blood glucose measurement at admission is inexpensive and universally available and may serve as a simple bedside prognostic indicator requiring validation in larger multicenter studies.