The role of neonatal procalcitonin and pro-inflammatory cytokines at birth in prediction of sepsis in neonates

Background: Septicemia, characterized by the presence of bacteria in the blood, is a life-threatening condition, particularly in neonates due to their underdeveloped immune systems. Early detection and prompt treatment are crucial for improving recovery outcomes. While several biomarkers have been proposed for diagnosing neonatal sepsis, none have proven fully reliable. This study aimed to investigate the potential of procalcitonin, IL-1β, IL-6, and TNF-α levels at birth as predictors for neonatal septicemia.

Methods: The study enrolled 246 neonates, collecting umbilical cord serum samples during delivery to analyze the levels of these biomarkers using enzyme-linked immunosorbent assay (ELISA). Neonates were monitored for a month, with those who developed septicemia forming the experimental group and those who did not serving as controls.

Results: Using the one-way analysis of variance (ANOVA), serum procalcitonin levels at birth was statistically significantly (p < 0.05) higher among neonates who developed septicemia in week 1 and 2 compare to the non-septicemic neonates. IL-6 and TNF-α also showed a statistically significant increase in neonates who developed septicemia in week 1. IL-1β showed no significant increase/decrease between septicemic neonates and non-septicemic neonates. PCT and TNF-α showed a strong positive correlation with neonatal septicemia while multiple regression analysis using IL-1β, IL-6, TNF-α and birth weight returned a statistically significant value; an indication of the predictive potentials of these markers in neonatal septicemia.

Conclusion: The study established that PCT and proinflammatory cytokines at birth are valuable biomarkers for predicting neonatal septicemia and should be integrated into clinical practice for early detection