CLINICAL CORRELATION OF NEONATAL AND MATERNAL HEMATOLOGICAL PARAMETERS AS PREDICTORS OF NEONATAL SEPSIS

36 ABSTRACT Objective: To evaluate the neonatal and maternal clinical manifestations and their hematological parameters, individually and in combination, as parameters which can be used to formulate a scoring system in determining neonatal sepsis. Design: A cross-sectional study conducted at the Neonatal Intensive Care Unit of a tertiary care teaching hospital. Methods: The study consisted of 100 neonates admitted at Neonatal Intensive Care Unit at the UP-PGH Medical Center who were clinically suspected of sepsis at birth and within 24 hours of life. A perinatal history, clinical profile, symptoms and laboratory data were recorded in each case. The neonatal hematological parameters included were total leukocyte count, total neutrophil count, lymphocytes, immature cells, immature to total leukocyte ratio, immature to mature cells ratio, nucleated red blood cells, lymphocytes, absolute neutrophil count, platelet count, and toxic granules. The maternal hematological parameters consisted of total leukocyte count, total neutrophil count, lymphocytes and platelet count. These parameters were evaluated based on the standard reference values. A blood culture was the standard indicator for proven sepsis. Results: There were 17 out of 100 neonates (17%) who had culture proven sepsis and they were predominantly preterm. Among the different parameters, the preterm infants, neonatal platelet count and maternal total leukocyte count were significantly associated with neonatal sepsis with p value of 0.047, 0.02, and 0.006 respectively. Based on these factors, a scoring system was devised to predict the probability of sepsis. A score of 3 had a 100% sensitivity and 91.3% specificity. Conclusion: A scoring system for predicting neonatal sepsis could be obtained by correlating the clinical manifestations of the neonate and the mother together with their hematological parameters. CLINICAL CORRELATION OF NEONATAL AND MATERNAL HEMATOLOGICAL PARAMETERS AS PREDICTORS OF NEONATAL SEPSIS