Prognostic Validity of Red Cell Distribution Width in Neonatal Sepsis

Abstract

Background Neonatal sepsis is one of the most critical illness in neonates that is responsible for a great proportion of morbidity and mortality in neonates so early diagnosis and identification of high risk cases is a challenging aim of our study. The purpose of this study was to investigate the prognostic value of red cell distribution width (RDW), in neonatal sepsis at the time of admission to neonatal intensive care unit (NICU). Materials and Methods This prospective case control study included 3 groups divided into Group 1: Neonates with sepsis (78 neonates), Group 2: Neonates with severe sepsis (42 neonates) Group 3: Neonates as a control group (60 neonates) were gender, gestational and postnatal ages matched. Red cell distribution width was determined for all included neonates. The score for neonatal acute physiology (SNAP II) was determined within 12 hours of admission to the NICU. Results One hundred and two sepsis newborns (85%), including 66 (64.7%) cases from sepsis group and 36 (35.3%) cases from severe sepsis group, the mortalities were 15.4% (n= 12), and 71.4% (n= 30) for group 1 and 2, respectively. The incidence of RDW increase in survivors group (45.7%) was significantly lower than in the non- survivors group (92.9%, n=39). The score for neonatal acute physiology (SNAP II) was positively correlated with RDW increase in newborns (r= 0.735 and p<0.05), and the mortality was positively correlated with RDW increase (r= 0.598 and P<0.05). Conclusion In our studyRDW is a helpful prognostic marker for early diagnosis of neonatal sepsis and identification of high risk cases.