IMMUNOGLOBULIN LEVELS OF NEONATES WITH RISK FACTORS FOR EARLY SEPSIS AT DIFFERENT GESTATIONAL AGES: COMPARATIVE ANALYSIS BETWEEN NEONATES WITH AND WITHOUT INFECTION. 1748

Abstract

OBJECTIVE: The high mortality in early sepsis is related to the presence of risk factors and to the neonate immunological state. The objective of this study was to do a comparative analysis of the immunological state of neonates with or without infection, at different gestational ages.METHODS: A prospective study with 60 newborns presenting one or more risk factors for early infection: clinical amnionitis, prolonged rupture of membranes or urinary tract infection was done. The newborns were classified into three groups of gestational age. I: 20 newborns ≥ 37 weeks, II: 20 newborns between 34 and 36 6/7 weeks, III: 20 newborns < 34 weeks. Blood samples were obtained from all newborns at birth and at the fifth day of life after family consent. Diagnosis of sepsis was based upon clinical and laboratorial criteria. The immunologic state was studied and analisys comparative was done between newborns with or without infection, into each group of gestational age. Immunoglobulin levels: IgG, IgM, IgA and total complement, at birth and at the fifth day of life, were studied. Statistical tests done were: Kruskal Wallis, Wilcoxon, Fisher and quisquare.RESULTS: Serum IgG levels were directly related to gestational age and in this study were higher when compared to current literature in all the groups. In groups II and III average serum IgG levels at birth were significantly different between neonates with or without infection, being lower in the infected neonates. This difference remained statistically significant at the fifth day of life only in group III. Serum IgM levels at birth were not related to gestational age and were significantly different in groups II and III at birth and in fifth day of life between neonates with or without infection. Serum IgA levels were undetectable in 96% of these cases at birth and in 80,5% at the fifth day.CONCLUSIONS: The rate of infection in newborn infant with risk factors for early sepsis seems to be correlated to IgM and IgG levels.