DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201137

Red cell distribution width as a diagnostic marker in neonatal sepsis

Anupama Deka, Aravind P.

Abstract


Background: The early diagnosis of neonatal sepsis, a significant cause of neonatal morbidity and mortality still remains a challenge. Red-cell Distribution Width (RDW) vary significantly in conditions associated with inflammation and infection like sepsis. The study aims to find the normal range of RDW in healthy newborns and investigate the role of RDW in the early diagnosis of neonatal sepsis.

Methods: This is a prospective observational study, 50 normal and 50 sepsis neonates were considered for the study. The neonatal sepsis group consisted of neonates with (i) Positive sepsis screen with/without clinical features of neonatal sepsis and/or (ii) Blood, urine or CSF culture positive or signs of pneumonia on chest x-ray. The mean RDW and the relationship between RDW and neonatal sepsis were analysed using appropriate statistical methods in SPSS-25 software.

Results: Mean RDW (%) was significantly higher in sepsis neonates (18.59±1.28) than in normal newborns (16.21±1.35). RDW had statistical significance with CRP (C-Reactive Protein) in the sepsis group. RDW had significant relationship with the diagnosis of neonatal sepsis with a p value of 0.000. An RDW cut-off level of 17.25% had 86% sensitivity, 87% specificity, and 93.5% accuracy in diagnosing neonatal sepsis.

Conclusions: RDW helps as a diagnostic test in the early diagnosis of neonatal sepsis.

 


Keywords


C-Reactive Protein, Neonatal sepsis, Pneumonia, Red-cell distribution width, Sepsis screen

Full Text:

PDF

References


Gupta P. Neonatal infections. In: PG Textbook of Pediatrics. 2nd Edition. Jaypee Brothers Medical Publishers (P) Ltd; 2018:596-633.

Ying F, Jia-Lin Y. Umbilical blood biomarkers for predicting early onset neonatal sepsis. World J. Pediatr. 2012;8(2):101-8.

Saxena R, Pati HP, Mahapatra M. Red Cell: Basic aspects of anaemia. In: De Gruchy’s Clinical Haematology in Medical Practice. Sixth Edition. Wiley India Pvt. Ltd.; 2013:15-32.

Gupta P. Approach to Diagnosis of Anemia. In: PG Textbook of Pediatrics. Second Edition. Jaypee Brothers Medical Publishers (P) Ltd.; 2018:1811-1825.

Chen J, Jin L, Yang T. Clinical study of RDW and prognosis in sepsis new borns. Biomed Res. 2014;25(4).

Kim J, Kim K, Lee JH, Jo YH, Rhee JE, Kim TY, et al. Red blood cell distribution width as an independent predictor of all-cause mortality in out of hospital cardiac arrest. Resuscitation. 2012 Oct 1;83(10):1248-52.

Abbasoglu A, Tugcu U, Ince DA, Yapakci E, Ecevit A, Tarcan A. PO-0514 Assessment of red cell distrubution width in neonatal sepsis as a prognostic factor. Arch Dis Childhood. 2014 Oct 1;99(Suppl 2):A417.

Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, Kang KW, Kim J, Rhee JE. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emergency Med. 2013 Mar 1;31(3):545-8.

Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009 Apr;133(4):628-32.

Tonbul A, Tayman C, Catal F, Kara S, Tatli MM. Red cell distribution width (RDW) in the newborn: normative data. J Clini Lab Analysis. 2011 Nov;25(6):422-5.

Park KI, Kim KY. Clinical evaluation of red cell volume distribution width (RDW). Yonsei Med J 1987;28:282-90.

Singh M, Sitaraman S, Choudhary R, Choudhary AS. Red Blood Cell Distribution Width as a Marker of Early Onset Neonatal Sepsis: A Hospital Based Analytical Study. JMSCR. 2019;07(08):59-65.

Cosar H, Yilmaz O, Temur M, Ozun OP, Bulut Y. Relationship between Early- Onset Neonatal Sepsis and Red Blood Cell Distribution Width (RDW). J Hematol Thrombo Dis. 2017,5:266.

Martin SL, Desai S, Nanavati R, Colah RB, Ghosh K, Mukherjee MB. Red cell distribution width and its association with mortality in neonatal sepsis. J Matern Fetal Neonatal Med. 2019;32(12):1925-30.

Abdullah ST, Moustafa AN, Mohsen Anwar A. Prognostic Validity of Red Cell Distribution Width in Neonatal Sepsis. Int J Pediatr. 2018;6(11):8579-86.