Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Neonatal sepsis is classified into 2 major categories: early onset neonatal sepsis, which usually presents with respiratory distress within 72 hours of age, and late onset sepsis that usually presents with septicemia after 72 hours of age. Umbilical cord evaluation is emerging as a potential means to aid in the earlier and more reliable detection of EOS, such as umbilical cord procalcitonin, CRP, I/T ratio, may be useful parameters to detect EOS. The purpose of our study was to evaluate the role of cord blood PCT, along with others cord blood markers (CRP, I/T ratio), as an early diagnostic markers for early onset neonatal sepsis, in preterm babies. The study included 74 preterm neonates, who were born at Obstetric Department, Cairo University Hospital, with gestational age between 28 and 36 weeks, of both gender. They were divided into 2 groups, group 1: 24 neonates with history suggesting materno-fetal infection, and showed signs of sepsis. Group2: 50 preterm baby of both sex, with no history suggesting materno-fetal infection and apparently healthy neonates, served as control group. Complete maternal and neonatal data were taken, 2 umbilical cord samples were collected and sent for analysis for (PCT, CRP, CBC). We found that, cord blood levels of PCT, CRP, neutrophils, I/T ratio and hemoglobin, were all elevated among septic preterm babies, with history suggesting materno-fetal infection, in comparison in control group and showed statistically significant difference between both groups. Sensitivity of cord blood I/ T ratio, was higher than the sensitivity of both umbilical cord PCT and CRP 83%, 50%, 45%, in predicting EOS among septic group. And this defined as a good positive test for prediction of EOS. The specificity of cord blood CRP was higher than PCT and I/T ratio, in prediction of EOS among septic group 98%, 84%, 50% respectively, and this defined as a good negative test

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