​Nucleated Red Blood Cell Count as Earliest Prognostic Marker for Adverse Neonatal Outcome in Neonatal Sepsis

ABSTRACT

Introduction: The most common cause of neonatal mortality is neonatal sepsis, the diagnosis of which depends on bloodculture, which has low sensitivity and takes time. We hypothesize that demonstration of elevated NRBC levels in neonatalsepsis might help in predicting an adverse neonatal outcome.Aim of the Study To analyse elevated NRBC it can serve as a prognostic marker for neonatal sepsis and an increased riskfor adverse neonatal outcome.Materials and Methods: This is a hospital based prospective study done in neonates who are admitted in NICU of MaduraiMedical College with risk factors or clinical features of sepsis. After getting informed consent, the maternal details and examinationfindings were recorded and blood sample taken for sepsis screen, blood culture and peripheral smear for NRBC.Results: The sensitivity of NRBC in identifying sepsis was 81.5%, its specificity was 61.76%, positive predictive value was 70.4%and negative predictive value was 75%. In the neonates who expired, serial NRBC counts (mean – 22.4) were significantlyincreased from baseline value (mean 17.3).Conclusion: NRBC is significantly elevated in the neonatal sepsis and is a predictor of adverse neonatal outcome.