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Category: Volume 07 Issue 08 August 2019
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Title: Red Blood Cell Distribution Width as a Marker of Early Onset Neonatal Sepsis: A Hospital Based Analytical Study

Authors: Dr Monu Singh, Dr S.Sitaraman, Dr Richa Choudhary, Dr Ajeet Singh Choudhary

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.09

Abstract

Background: Neonatal sepsis is still a significant cause of neonatal morbidity& mortality and its early diagnosis still remains a challenge. Present study aimed to investigate Red cell Distribution Width (RDW) as a marker of early onset neonatal sepsis (EONS).

Material and Methods: A hospital based cross sectional analytical study was conducted at department of paediatrics, at a tertiary care centre of western India, including 55 early onset neonatal sepsis cases and 55 controls.  Newborn delivered by spontaneous vaginal delivery with gestational age of 36 weeks or more presenting within 72 hours of delivery with signs & symptoms suggestive of early onset neonatal sepsis were taken as cases and age and weight-matched healthy new-born were taken as control. 

Observations: Mean RDW level was significantly higher (p<0.001) in EONS (21.31 ± 3.08 %) as compared to healthy controls (16.23 ± 1.16%). TLC was also significantly higher (p<0.001) in EONS (18.92 ± 8.01x103/dl) as compared to controls (12.19 ± 9.29x103/dl). The area under the ROC curve for RDW was 0.988 (0.973 – 1.000), which indicated that RDW was a good predictor of EONS (p<0.001). The Critical cut off point was found to be 18.55 using Youden’s index with a sensitivity of 94.55% and specificity of 96.36% for diagnosis of EONS.

Conclusion: Red cell distribution width can be used as a cheap, easy, rapid and accurate marker for rapid identification of early onset neonatal sepsis.

Keywords: Neonatal sepsis, early onset neonatal sepsis, Red cell distribution width, RDW.

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Corresponding Author

Dr Ajeet Singh Choudhary

Junior Resident, Dept of Internal Medicine, S.M.S Medical College, Jaipur, India