[Inflammatory and clinical markers predicting mortality in neonates under 1500 g]

Early neonatal mortality occurs within 7 days of life. Clinical variables, inflammatory markers and CRIB (Clinical Risk Index for Babies) could be useful to identify mortality risk.

To assess the predictive value of inflammatory and clinical markers for early mortality in preterm newborns (PTNB) < 1500 g.

Analytical, retroprospective, observational and cross-sectional study. PTNBs with birth weight < 1500 g were included. Clinical characteristics, CRIB, inflammatory markers and C-reactive protein (CRP) were evaluated at 12 hours of life.

248 PTNBs were studied, with a gestational age of 32 weeks (IQR 30-34), weight 1285 g (IQR 1070-1400); 20 died (8.06%). Risk factors for mortality were weight ≤ 1000 g, OR = 24 (7.69-77.96), p < 0.0001; gestational age ≤ 28 weeks, OR = 42 (13.71-128.61), p < 0.0001; invasive ventilation, OR = 44.7 (5.85-340), p < 0.0001. Protective factors were antenatal corticosteroids, OR = 0.15 (0.05-0.39), p = 0.0001, and maternal preeclampsia, OR = 0.13 (0.01-1.02), p = 0.01. CRP, base deficit and birth weight were associated with mortality in the multivariate analysis (intercept = 6.62; SE = 1.85; R2 = 0.60; p = 0.0003). CRP ≥ 2.30 µg/dL showed a sensitivity of 26.32% and a specificity of 97.50% for mortality, AUC = 0.69, p = 0.005.

Predictors of early mortality were weight ≤ 1000 g, gestational age ≤ 28 weeks and CRP ≥ 2.30 microg/dL.