Calcemia and Inflammatory Markers in Early-Onset Neonatal Infection

Area of Science:

• Neonatology
• Pediatric Infectious Diseases
• Clinical Chemistry

Background:

• Ionized hypocalcemia is frequently observed in neonates diagnosed with sepsis.
• This study investigates total calcemia (S-Ca) and its association with infection markers.

Purpose of the Study:

• To evaluate total calcemia (S-Ca) in neonates with early-onset infection.
• To determine the relationship between S-Ca and laboratory markers of infection, specifically C-reactive protein (S-CRP) and procalcitonin (S-PCT).

Main Methods:

• Retrospective analysis of 29 full-term neonates with early-onset infection.
• Comparison with a control group of 705 neonates without infection.
• Evaluation of serum calcium (S-Ca), S-CRP, and S-PCT levels.

Main Results:

• Neonates with early-onset infection exhibited significantly lower S-Ca on days 1, 2, and 3 compared to controls (p < 0.0001).
• Pooled S-Ca was significantly lower in the infected group (p < 0.0001).
• A weak negative correlation was observed between pooled S-Ca and S-PCT (r = -0.22, p = 0.06) and S-CRP (r = -0.19, p = 0.09).

Conclusions:

• Total calcemia (S-Ca) is decreased in neonates with early-onset infection.
• A slight inverse correlation exists between S-Ca and infection markers S-CRP and S-PCT.
• Pediatricians should consider decreased S-Ca as a potential indicator of neonatal infection and recognize the increased risk of hypocalcemia in infected neonates.