Cord blood inflammatory markers for the diagnosis of early-onset neonatal sepsis

Abstract

Objective: The present study was design to screen early-onset neonatal sepsis using cord blood inflammatory markers. Additionally, the study compared suitable inflammatory markers for septic screen using cord blood. Study Design: This single-centre observational study included neonates suspected of early onset neonatal sepsis having gestational age >28 weeks and weight >1000gm, delivered at a Tertiary Care Centre. Cord blood was collected immediately after birth (0 hour) and clinical parameters (i.e., C-reactive protein (CRP), interleukin 6 (IL-6), procalcitonin, blood culture) as well as haematological parameters (i.e., absolute neutrophil count (ANC), white blood cell count (WBC)) associated with early-onset neonatal sepsis were examined. Results: The study included 44 neonates of mean gestational age of 36.1 ± 3.2 weeks. Receiver operating characteristic curve (ROC) for sepsis markers showed that procalcitonin demonstrated the highest sensitivity and specificity of 90.9% and 100%, respectively; AUC of 0. 966 (95% CI, 0.862-0.998, p <0.001) with cut off ≤0.48. IL-6 significantly predicted early-onset neonatal sepsis with an AUC of 0.965 (95% CI, 0.861-0.997, p <0.001); optimum cut off ≤ 6.4pg/ml with sensitivity and specificity of 90.9% and 95.5%, respectively.