Early Onset Sepsis Risk Calculator and Vitamin D Level in Newborn Exposed to Premature Rupture of Membranes

Abstract

Helmy AS, ELMeneza SA, ELBagoury IM

Background: Neonatal sepsis is an important cause of morbidity and mortality.
Aim of work: Study the diagnostic value of early-onset sepsis risk calculator (EOSR) and vitamin D as markers for early diagnosis of sepsis among the newborn infants > 34 weeks who were exposed to premature rupture of membrane (PROM).
Patients and Methods: This observational case-control study included 100 newborn infants > 34 weeks of gestation. Newborn infants were assigned into two groups according to the development of sepsis and exposure to PROM: septic and control groups. Kaiser EOSR calculator was used. Vitamin D was estimated by ELISA.
Results: There was a significant increase of EOSR calculator mean values in the septic group than the control group at birth and after clinical examination. The median ± IQR was 10.26 (5.3-24) per 1000/birth at birth in the sepsis group and 0.47(0.39 – 0.67) in the control group. EOSR calculator was 63.2 (25.5 – 142.6) per 1000/births after clinical examination in the septic group and 0.19(0.16 – 0.27) in the control group, P-value was < 0. 001. There was a significant decrease in vitamin D in the septic group (8.57 ± 9.14 ngL) than the control group (50.61 ± 12.55ngL), the P-value was <0.001.
Conclusion: Early-onset sepsis risk calculator and vitamin D have high sensitivity and specificity in predicting sepsis among infants exposed to PROM, these may decrease the unnecessary use of prophylactic antibiotics among infants > 34 weeks of gestation. Estimation of vitamin D in neonates with equivocal EOSR calculator score may assist in the early management.