Relationship of early-onset sepsis and neonatal encephalopathy: early-onset sepsis can increase short-term adverse outcomes of neonatal encephalopathy

Li Yang; Shirui Zhu; Mei Xue; Jianping Zhang; Ling Li; Beibei Wang; Jun Zhang

doi:10.5114/fn.2026.159243

eISSN: 1509-572x
ISSN: 1641-4640

Folia Neuropathologica

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abstract:

Original paper

Relationship of early-onset sepsis and neonatal encephalopathy: early-onset sepsis can increase short-term adverse outcomes of neonatal encephalopathy

Li Yang

¹

,

Shirui Zhu

²

,

Mei Xue

²

,

Jianping Zhang

²

,

Ling Li

²

,

Beibei Wang

²

,

Jun Zhang

³

The Affiliated Hospital of Yangzhou University Medical College (Taizhou People’s Hospital)/Neonatology, China
The Affiliated Taizhou People’s Hospital of Nanjing Medical University/Neonatology, China
Department of Nuclear Medicine, Yangzhou University, Yangzhou, China

Folia Neuropathol 2026; 64 (1)

DOI: https://doi.org/10.5114/fn.2026.159243

Online publish date: 2026/02/12

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Introduction
It has been reported that neonatal encephalopathy (NE) with early-onset sepsis (EOS) may have worse outcomes in comparison to non-septic NE. The aim of this study was to evaluate the association of EOS and short-term adverse outcomes of NE.

Material and methods
This retrospective observational study evaluated the short-term outcomes of NE patients with and without EOS at the The Affiliated Hospital of Yangzhou University Medical College Hospital between July 2021 and July 2024. Eighty-seven patients with mild NE were included in the study, 21 of whom also had EOS (EOSNE group) and 66 of whom did not have EOS (NE group), and these two groups were used to compare the short-term outcomes.

Results
Abnormal neurological examinations were found in 42.9% of the EOSNE group vs. 19.7% of the NE group, which was significantly higher in the EOSNE group (p = 0.03). The seizure rate until discharge day in the EOSNE group was 38.1% vs. 15.2% in the NE group, which was significantly higher in the EOSNE group (p = 0.02). Abnormal electroencephalogram (EEG) findings were observed in 47.6% of the EOSNE group vs. 15.2% of the NE group (p = 0.004). Also, 47.6% of the EOSNE group vs. 15.2% in the NE group used antiplatelet medications until discharge day, which was significantly higher in the EOSNE group (p = 0.004). The proportion of patients receiving blood products was significantly higher in the EOSNE group (57.1% vs. 15.2% p = 0.001).

Conclusions
The rate of hospitalization in EOSNE patients was higher than in NE patients. Abnormal neurological examinations, abnormal EEG, seizures, receipt of blood products, and use of antiepileptic drugs were more common in these patients.

keywords:

Relationship of early-onset sepsis and neonatal encephalopathy: early-onset sepsis can increase short-term adverse outcomes of neonatal encephalopathy

Li Yang 1 , Shirui Zhu 2 , Mei Xue 2 , Jianping Zhang 2 , Ling Li 2 , Beibei Wang 2 , Jun Zhang 3

neonatal encephalopathy, early-onset sepsis, encephalopathy

Li Yang

¹

,

Shirui Zhu

²

,

Mei Xue

²

,

Jianping Zhang

²

,

Ling Li

²

,

Beibei Wang

²

,

Jun Zhang

³