Evaluation of Cord Blood - Haematological Scoring System as an Early Predictive Screening Method for the Detection of Early Onset Neonatal Sepsis

Abstract

Background: Sepsis is one of the major causes of neonatal morbidity and mortality. Early recognition and diagnosis of neonatal sepsis are difficult because of the variable and nonspecific clinical presentation of this condition. Hence, there is a need for early predictive screening method for neonatal sepsis. Objectives: To evaluate the role of Cord blood Haematological Scoring System as an early predictive screening method for detection of early onset neonatal sepsis and also to identify the neonates who are at risk of developing neonatal sepsis using cord blood. Settings and Design: The present prospective cross-sectional study was conducted by taking 153 cord blood samples of full term newborns immediately after delivery in the hospital. Preterm, still birth and emergency deliveries were excluded from the study. Materials and Methods: The cord blood was collected and analysed for various Haematological parameters like Total leucocyte count, Absolute Neutrophil count, Immature to mature Neutrophil ratio, immature to mature ratio, Neutrophil morphology, nucleated erythrocytes, platelet count, micro erythrocyte sedimentation rate. Blood cultures were performed as gold standard for diagnosing neonatal sepsis. Statistical Analysis: Chi-square test, Risk ratio, risks in exposed and risk in unexposed were performed. Results: Of 153 newborns for analysis, 59 (38.56%) developed sepsis. The haematological scoring system found that an abnormal immature to total neutrophil ratio, Neutropenia, micro erythrocyte sedimentation rate followed by an abnormal immature to mature neutrophil ratio were the most sensitive indicators in identifying infants with sepsis. The study also found that higher the score, the greater the certainty of sepsis being present. Conclusion: The haematological scoring system using cord blood can be considered as an early predictive screening method for detection of early onset neonatal sepsis. Identifying the risk of developing sepsis early can prevent morbidity and mortality of the neonates.

Keywords

• blood culture
• neutrophil count
• nucleated erythrocytes
• platelet count