IMMUNOLOGICAL MARKERS IN NEONATES WITH RISK FACTORS FOR EARLY SEPSIS AT DIFFERENT GESTATIONAL AGES. 1705

Abstract

OBJECTIVE: The early diagnosis of sepsis is difficult and the objective of this study was to determine possible markers of infection in neonates with risk factors for early infection.METHODS: A prospective study with 60 newborns that presented 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 ages. I: 20 newborns≥ 37 weeks, II: 20 newborns between 34 a 36 6/7 weeks, III: 20 newborns< 34 weeks. Blood samples were withdrawn from all newborns at birth and at the fifth day of life after family consent.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 and the immunologic markers were performed: Immunoglobulins levels (IgG, IgM, IgA), total complement and C-reactive protein, at birth and at the fifth day of life. The statistical tests done were: Kruskal Wallis, Wilcoxon, Fisher and qui-square.RESULTS: Among 60 newborns studied 15 (25%) had sepsis. The group with gestational age < 34 weeks showed highest rates of infection and of deaths related to infection when compared with others groups. The best markers of infection in all groups at birth and in the fifth day of life were IgM serum levels (only when equal to or superior to 100 mg/dl) and C-reactive protein at the fifth day of life, were related to a worse outcome.CONCLUSIONS: These results suggest that with risk factors for early sepsis, the study of C-reactive protein and IgM levels at the birth day and in the fifth day of life can improve the diagnostic, the therapeutic and the prognosis of the infection.