Pantea Manuela, Kalapala Chaitanya, Thakur Barkha Rani, Iacob Daniela, Borțea Claudia Ioana, Herlo Alexandra, Marc Felicia, Tanasescu Sonia, Bucur Adina
Department of Neonatology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
J Pers Med. 2024 Jun 22;14(7):672. doi: 10.3390/jpm14070672.
The incidence of Neonatal Systemic Inflammatory Response Syndrome (SIRS) is a critical concern in neonatal care. This study aimed to identify maternal laboratory parameters predictive of SIRS in newborns, focusing on the establishment of diagnostic cutoffs and evaluating the predictive power of these biomarkers. This prospective cohort study was conducted from January 2023 to January 2024 across several regional hospitals specializing in neonatal care. It included 207 mother-newborn pairs, divided into groups based on the neonatal development of SIRS (66 cases) or its absence (141 controls). Key maternal parameters measured included inflammatory markers and liver enzymes, analyzed using standard biochemical methods. The study applied receiver operating characteristic (ROC) analysis to establish optimal cutoff values and conducted multivariate logistic regression to determine hazard ratios (HRs) for SIRS prediction, with adjustments for potential confounders. The study identified significant ROC/AUC values for several biomarkers. The neutrophil-to-lymphocyte ratio (NLR) demonstrated an AUC of 0.926, with a cutoff value of 3.64, achieving 81.8% sensitivity and 90.9% specificity ( < 0.001). The systemic immune-inflammation index (SII) showed an AUC of 0.819 and a cutoff of 769.12, with 75.8% sensitivity and 81.8% specificity ( < 0.001). Multivariate regression analysis highlighted that neonates with maternal SII values above this cutoff were three times more likely to develop SIRS (HR 3.09, 95% CI 2.21-4.17, < 0.0001). Other notable biomarkers included dNLR and ALRI, with respective HRs of 1.88 ( = 0.018) and 1.75 ( = 0.032). These findings confirm the significant predictive value of specific maternal inflammatory markers for neonatal SIRS. These findings support the utility of these biomarkers in prenatal screening to identify neonates at increased risk of SIRS, potentially guiding preemptive clinical interventions.
新生儿全身炎症反应综合征（SIRS）的发病率是新生儿护理中的一个关键问题。本研究旨在确定可预测新生儿SIRS的母亲实验室参数，重点是建立诊断临界值并评估这些生物标志物的预测能力。这项前瞻性队列研究于2023年1月至2024年1月在几家专门从事新生儿护理的地区医院进行。研究纳入了207对母婴，根据新生儿是否发生SIRS分为两组（66例发生SIRS，141例为对照）。测量的关键母亲参数包括炎症标志物和肝酶，采用标准生化方法进行分析。该研究应用受试者操作特征（ROC）分析来确定最佳临界值，并进行多因素逻辑回归以确定SIRS预测的风险比（HR），同时对潜在混杂因素进行调整。该研究确定了几种生物标志物的显著ROC/AUC值。中性粒细胞与淋巴细胞比值（NLR）的AUC为0.926，临界值为3.64，灵敏度为81.8%，特异度为90.9%（<0.001）。全身免疫炎症指数（SII）的AUC为0.819，临界值为769.12，灵敏度为75.8%，特异度为81.8%（<0.001）。多因素回归分析强调，母亲SII值高于此临界值的新生儿发生SIRS的可能性高出三倍（HR 3.09，95%CI 2.21-4.17，<0.0001）。其他值得注意的生物标志物包括dNLR和ALRI，其HR分别为1.88（=0.018）和1.75（=0.032）。这些发现证实了特定母亲炎症标志物对新生儿SIRS具有显著的预测价值。这些发现支持了这些生物标志物在产前筛查中的作用，以识别SIRS风险增加的新生儿， potentially guiding preemptive clinical interventions.（此处原文有误，应改为“potentially guiding preemptive clinical interventions”，意为“潜在地指导预防性临床干预”）从而可能指导预防性临床干预。
