Herzlich Jacky, Waksman Yarden, Marom Ronella, Berliner Shlomo, Mandel Dror, Mangel Laurence
Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Tel Aviv University, Tel Aviv, Israel.
Sci Rep. 2025 May 23;15(1):18031. doi: 10.1038/s41598-025-02337-9.
C-reactive protein (CRP) is a well-established marker of inflammation in neonates. Recent studies have shown the potential of CRP velocity as an early indicator of infection disorders in children and adults. However, data on CRP dynamics in the neonatal population remain limited. Our objective was to assess the dynamics of CRP levels and determine their clinical relevance in newborns admitted to the nursery. This is a retrospective review of medical records of neonates ≥ 35 weeks of gestation with a birth weight of ≥ 2000 g, who underwent partial sepsis work-up with at least 2 consecutive CRP measurements within the first 48-h of life, between January and December 2020. CRP dynamics were analyzed using CRP velocity (CRPv, mg/L/h), calculated by dividing the interval between the first two consecutive CRP measurements by the corresponding interval time. A total of 212 neonates were included in the study. Neonates admitted to the neonatal intensive care unit (NICU) presented with higher levels of CRPv (p = 0.047), and were more likely to experience hypoglycemia (p = 0.023) and respiratory distress (p = 0.023). Lower CRPv levels were associated with elective cesarean surgery (p = 0.043). Among neonates with CRPv ≥ 2 mg/L/h, female infants exhibited even higher CRPv values (p = 0.018). Only two cases of blood culture-confirmed neonatal sepsis were identified, with CRPv values of 3.22 and 0.02 mg/L/h., Neither case required NICU admission. Regression analyses revealed that higher gestational age was significantly associated with elevated CRPv levels (p = 0.004) whereas hypothermia was linked to lower CRPv values (p = 0.031). In neonates, CRP dynamics generally corresponded to their overall clinical condition but were also influenced by various non-infectious factors, including GA, mode of delivery and gender. Additionally, neonatologists should consider the recent finding that neonatal hypothermia was associated with decreased CRP levels when assessing ill-appearing newborns with low CRP measurements.
C反应蛋白（CRP）是新生儿炎症的一个公认标志物。最近的研究表明，CRP变化速率有潜力作为儿童和成人感染性疾病的早期指标。然而，关于新生儿群体中CRP动态变化的数据仍然有限。我们的目的是评估CRP水平的动态变化，并确定其在入住新生儿病房的新生儿中的临床相关性。这是一项对2020年1月至12月期间孕周≥35周、出生体重≥2000g、在出生后48小时内至少连续进行2次CRP测量以进行部分败血症检查的新生儿病历的回顾性研究。使用CRP变化速率（CRPv，mg/L/h）分析CRP动态变化，CRPv通过将前两次连续CRP测量之间的间隔除以相应的间隔时间来计算。共有212名新生儿纳入研究。入住新生儿重症监护病房（NICU）的新生儿CRPv水平较高（p = 0.047），且更有可能出现低血糖（p = 0.023）和呼吸窘迫（p = 0.023）。较低的CRPv水平与择期剖宫产手术有关（p = 0.043）。在CRPv≥2mg/L/h的新生儿中，女婴的CRPv值更高（p = 0.018）。仅发现2例血培养确诊的新生儿败血症病例，CRPv值分别为3.22和0.02mg/L/h。两例均无需入住NICU。回归分析显示，较高的孕周与CRPv水平升高显著相关（p = 0.004），而体温过低与较低的CRPv值相关（p = 0.031）。在新生儿中，CRP动态变化通常与其整体临床状况相符，但也受到包括孕周、分娩方式和性别在内的各种非感染因素的影响。此外，新生儿科医生在评估CRP测量值低且情况不佳的新生儿时，应考虑到新生儿体温过低与CRP水平降低相关这一最新发现。
