Absolute Neutrophil Count as Predictor of Early Onset Sepsis

Abstract

Background: Infant mortality rate (IMR) was found to increase in the newborn. The most frequent causes of death are infection, prematurity, low birth weight (LBW), neonatal asphyxia and birth trauma, respectively. Absolute neutrophil count (ANC) can be used as a marker of infection because of its faster, easier, simpler and cheaper nature. Objective: The study aims to identify the influence of an increase and decline in ANC on newborns from mothers with risk factors for early onset sepsis. Methods: This study was conducted as a a prospective cohort study from December 2013 to July 2014. The population included 120 newborns whose mother has risk factors of early onset sepsis and admitted to Dr. Wahidin Sudirohusodo Hospital, and joined hospital. The subjects were divided into three groups, ANC <1800/mm3, ANC 1800-5399/mm3 and ANC >5400/mm3. Results: Newborn from mother with risk factor of infection with ANC >5400/mm3 and ANC 1800-5399/mm3 shows a significant difference with p = 0.000 (p<0.001); OR 8.143; IK 95% 2.440-27.173. Cut off point of 10.710-10890/mm3 was found from ROC analyses in ANC >5400/mm3 group with sensitivity and specificity 89.47% and 80.95% respectively; PPV (Positive predictive value) 80.95%; NPV (Negative predictive value) 89.47%; p=0.000; OR 36.125; IC 95% 5.820-224.224. Conclusions: Absolute neutrophil count >10.710/mm3 in a term newborn from mother with infection risk factors can be used as predictor for early onset sepsis 36 fold higher than the ANC <10.710/mm3.