Abstract

Background: Preterm neonates are susceptible to various complications that require invasive procedures that can be risky for sepsis, which is the third leading cause of mortality in children. Early identification of neonatal mortality related to sepsis through the use of laboratory values that routinely obtained such as red-cell distribution width (RDW) and immature to total neutrophil (IT) ratio is necessary, considering the use of both markers as predictors of sepsis mortality in preterm neonates is still limited.

Objective: To analyze the predictive ability of RDW and IT/ratio on sepsis mortality in preterm neonates.

Methods: Prospective cohort study using 42 preterm neonates (gestational age 28-36 weeks + 6 days) with birth weight appropriate to its gestational age. The diagnosis of sepsis was established based on the high probable sepsis (HPS) and probable sepsis (PRS) criteria scores. RDW and IT/ratio values were obtained at the first of the sepsis diagnosis. Neonatal mortality was observed during the first 28 days of life. The analysis used was the Receiving Operating Characteristic (ROC) curve.

Results: The RDW value in preterm neonates who died was 16.5% with a range of 14.0-32.7%; relatively similar to the RDW value in preterm neonates who were still alive (16.25% in the range of 14.6-34.3%). ROC curve analysis obtained an area under curve (AUC) value of 0.541 (95% CI: 0.359-0.722) with p=0.656. The I/T ratio value in preterm neonates who died was 0.13 in the range of 0.03-0.22, relatively the same as the IT/ratio value in preterm neonates who were still alive (0.15 with a range of 0.11-8.20). The AUC value obtained was 0.387 (95% CI: 0.214-0.559) at
p=0.213.

Conclusion: RDW and IT/ratio values cannot be used as predictors of sepsis mortality in preterm neonates.