To investigate the risk factors of short-term poor prognosis of neonatal purulent meningitis.

The clinical data of 76 cases of neonatal purulent meningitis treated in the Neonatology Department of Hebei Provincial People′s Hospital from September 2015 to January 2021 were retrospectively analyzed. According to their outcomes of 6-12 months, they were divided into the good prognosis group (n=46) and the poor prognosis group (n=30). The newborn′s general situation, birth history, clinical features, laboratory examination results and pathogenic species were compared between the two groups. Multivariable logistic regression was used to analyze the factors associated with poor outcome, and the ROC curve to assess the effectiveness of each index in predicting prognosis.

In the poor prognosis group, the proportion of male (23/30, 76.67%), the proportion of low gestational age (13/30, 43.33%), the proportion of low birth weight (8/30, 26.67%), the proportion of complicated with consciousness disorder (13/30, 43.33%), and the proportion of electrolyte abnormalities (9/30, 30.00%) were higher than those in the good prognosis group [52.17%(24/46), 2.17%(1/46), 2.17%(1/46), 21.74%(10/46), 2.17%(1/46)], the differences between the two groups were statistically significant (χ²=4.62, 4.01, 9.99, all P<0.05). The CSF white blood cell count [435(165, 875)×10⁶/L] and CSF protein level [1.54(0.90, 2.38)g/L] in the poor prognosis group were higher than those in the good prognosis group [78(32, 305)×10⁶/L, 0.70(0.57, 1.02)g/L)], and the CSF glucose/blood glucose ratio [0.37(0.27, 0.53)] was lower than that in the good prognosis group [0.54(0.46, 0.68)]. The differences between the two groups were statistically significant (Z=-3.78, -4.72, -3.26, all P<0.01). Logistic regression analysis showed that CSF white blood cell count, CSF protein level and CSF glucose/blood glucose ratio were risk factors for poor prognosis (OR=1.002, 2.840, 0.056; all P<0.05). The ROC curve showed that area under the curve (AUC) of CSF white blood cell count, CSF protein level, CSF glucose/blood glucose ratio, and the combined model were 0.800, 0.822, 0.769, and 0.879, respectively.

High CSF white blood cell count, low CSF glucose/blood glucose ratio and high CSF protein level are independent risk factors for short-term poor prognosis of neonatal purulent meningitis.