Department of Neonatology, Faculty of Medicine, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
J Matern Fetal Neonatal Med. 2022 Dec;35(23):4552-4557. doi: 10.1080/14767058.2020.1856068. Epub 2020 Dec 6.
To identify whether the first plasma C-reactive protein values taken 6-8 h postpartum are predictive of the clinical early-onset neonatal sepsis (cEONS).
We retrospectively analyzed C-reactive protein (CRP) values of 400 neonates, including 28 with cEONS, who underwent plasma CRP measurements as part of sepsis work-up. To determine whether the first CRP measurement is predictive of cEONS, logistic regression was used with CRP as an independent variable and cEONS (yes/no) as a dependent variable.
A moderate predictive ability of the first CRP measurement (odds ratio 1.4, CI: [1.13, 1.76], =.003) was revealed, at a 5.3 mg/L threshold. However, it resulted in poor sensitivity of 50%, and a false positive rate of 30%. Increasing the sensitivity to 75% or 90% lead to increased false-positive rates of 55% and 75%, respectively.
Our findings suggest that the first CRP value taken in neonates is a weak predictor of cEONS.
确定产后 6-8 小时内首次测量的血浆 C 反应蛋白值是否可预测临床早发性新生儿败血症（cEONS）。
我们回顾性分析了 400 名接受血浆 CRP 测量的新生儿（包括 28 名 cEONS 患儿）的 CRP 值，这些患儿均为败血症检查的一部分。为了确定首次 CRP 测量是否可预测 cEONS，我们使用逻辑回归，将 CRP 作为自变量，cEONS（是/否）作为因变量。
首次 CRP 测量具有中等的预测能力（优势比 1.4，CI：[1.13, 1.76]，=0.003），截断值为 5.3mg/L。但是，其灵敏度仅为 50%，假阳性率为 30%。为了提高灵敏度至 75%或 90%，假阳性率将分别增加至 55%和 75%。
我们的研究结果表明，新生儿首次 CRP 值是 cEONS 的一个弱预测指标。
