CLINICAL PREDICTION OF EARLY ONSET SEPSIS IN PRETERM NEONATES

The aim of the study was to analyze and identify risk factors for the development of early onset sepsis in preterm neonates and to develop a clinical prognostic model.

Materials and methods: A retrospective cohort study included 152 newborns with birth weight from 1000 to 2500 g, who were treated in the neonatal intensive care units of medical institutions in the Poltava region. Among 152 children, 121 had clinical and laboratory symptoms of infection, which were regarded as manifestations of early onset sepsis, the rest of the children (n = 31) had no manifestations of infection.

Results: According to the results of multiple stepwise logistic regression analysis, the predictive model has been developed. It included gestational age, visual changes of placenta, Apgar score at the 1st minute, the level of monocytes more than 6.5%, the history of abortions and premature rupture of membranes. The diagnostic characteristics of the developed model had high: sensitivity - 82.2%, specificity - 93.55%, positive predictive value - 97.98%, negative predictive value - 58%.

Conclusions: The prognostic model developed by us, which showed high diagnostic characteristics, includes information on maternal risk factors, the state of the newborn immediately after birth, and biomarkers of infection (C-reactive protein and monocyte count). Therefore, we believe that when interpreting biomarkers, the decision to prescribe antibiotics should be based on the presence of maternal risk factors and clinical symptoms of infection in the prematurely born child, which may be nonspecific.