Aggarwal Juhi, Batra Jyoti, Midha Urvashi, Aggarwal Alka, Khan Mahmood Ahmad, Rohil Vishwajeet
Department of Biochemistry, Vallabhbhai Patel Chest Institute (VPCI), University of Delhi, India.
Department of Biochemistry, Santosh Medical College and Hospital (SDTU), Ghaziabad (U.P.), India.
Pediatr Endocrinol Diabetes Metab. 2025;31(1):17-24. doi: 10.5114/pedm.2025.148398.
Neonatal sepsis is the third leading cause of neonatal mortality, which occurs due to bacterial infection and is a major public health problem, especially in developing countries. Efforts to reduce the rates of infection in this vulnerable population are one of the most important interventions in neonatal care. This study aimed to compare the levels of biomarkers such as presepsin, procalcitonin, interleukin 6 (IL-6), fetuin, and CRP in cord blood between preterm and term infants and evaluate their association with neonatal sepsis.
A total of 176 infants were included in this study. Cord blood samples were collected from preterm (gestational age < 37 weeks) and term (gestational age ≥ 37 weeks) infants immediately after delivery. Umbilical cord blood was assessed for C-reactive protein (CRP), presepsin, procalcitonin, IL-6, and fetuin by using enzyme-linked immunosorbent assay (ELISA). The Pearson correlation coefficient test (r) was used to test for a positive or negative relationship between 2 (presepsin and fetuin) variables with CRP and procalcitonin. A receiver operating characteristic (ROC) analysis was executed to describe a cutoff value of the studied biomarkers.
When compared to term newborns, preterm infants have considerably higher values for CRP, presepsin, procalcitonin, and IL-6. Elevated levels of presepsin, procalcitonin, and IL-6 in cord blood were significantly associated with an increased risk of neonatal distress in both preterm and term infants (p < 0.05). Fetuin levels showed a trend towards association with neonatal distress but did not reach statistical significant. A Pearson correlation study between CRP and presepsin and fetuin shows that CRP is positively correlated with presepsin; however, procalcitonin shows positive correlation with fetuin. Further, these results were confirmed with ROC analysis.
In early diagnosis of neonatal sepsis, compared with procalcitonin, presepsin and IL-6 seems to provide better early diagnostic value with consequent rapid therapeutic decision making and possible positive impact on neonatal prognosis. Elevated levels of these biomarkers are associated with risk of neonatal distress, highlighting their potential utility as early markers for identifying at-risk infants.
新生儿败血症是新生儿死亡的第三大主要原因，由细菌感染引起，是一个重大的公共卫生问题，在发展中国家尤为突出。降低这一脆弱人群感染率的努力是新生儿护理中最重要的干预措施之一。本研究旨在比较早产儿和足月儿脐带血中可溶性髓系细胞触发受体-1（presepsin）、降钙素原、白细胞介素6（IL-6）、胎球蛋白和C反应蛋白（CRP）等生物标志物的水平，并评估它们与新生儿败血症的关联。
本研究共纳入176例婴儿。在分娩后立即从早产儿（胎龄<37周）和足月儿（胎龄≥37周）采集脐带血样本。采用酶联免疫吸附测定（ELISA）法检测脐带血中的C反应蛋白（CRP）、可溶性髓系细胞触发受体-1（presepsin）、降钙素原、IL-6和胎球蛋白。使用Pearson相关系数检验（r）来检验两个变量（可溶性髓系细胞触发受体-1和胎球蛋白）与CRP和降钙素原之间的正相关或负相关关系。进行受试者工作特征（ROC）分析以确定所研究生物标志物的临界值。
与足月儿相比，早产儿的CRP、可溶性髓系细胞触发受体-1、降钙素原和IL-6水平显著更高。脐带血中可溶性髓系细胞触发受体-1、降钙素原和IL-6水平升高与早产儿和足月儿发生新生儿窘迫的风险增加显著相关（p<0.05）。胎球蛋白水平显示出与新生儿窘迫有关联的趋势，但未达到统计学显著性。CRP与可溶性髓系细胞触发受体-1和胎球蛋白之间的Pearson相关性研究表明，CRP与可溶性髓系细胞触发受体-1呈正相关；然而，降钙素原与胎球蛋白呈正相关。此外，这些结果通过ROC分析得到了证实。
在新生儿败血症的早期诊断中，与降钙素原相比，可溶性髓系细胞触发受体-1和IL-6似乎具有更好的早期诊断价值，从而能够迅速做出治疗决策，并可能对新生儿预后产生积极影响。这些生物标志物水平升高与新生儿窘迫风险相关，突出了它们作为识别高危婴儿早期标志物的潜在效用。
