Early-onset neonatal sepsis: cord blood cytokine levels at diagnosis and during treatment.

OBJECTIVE To assess clinical and laboratory parameters and serum cytokine levels in 55 neonates who developed early-onset sepsis. METHODS Clinical parameters associated with early-onset neonatal sepsis were assessed. White blood cell differential and serum C-reactive protein and glucose levels were measured upon diagnosis of sepsis and 48 hours later. IL-beta, IL-10, IL-6, and TNF-α levels were measured in cord blood samples obtained on the day of diagnosis and from samples collected 48 and 96 hours after treatment onset. RESULTS Among newborns with early-onset sepsis, the length of hospital stay was inversely correlated with birth weight. Clinical parameters varied widely, especially body temperature. Blood glucose changes - particularly hypoglycemia - were common. Leukopenia, usually due to neutropenia, was the most prevalent change in blood cell count. C-reactive protein levels correlated with the immature-to-total neutrophil ratio. Serum TNF-α and IL-10 levels measured early in the course of sepsis were positively correlated with those detected in cord blood. CONCLUSIONS Clinical and laboratory parameters varied widely among neonates with sepsis in this sample. In neonates who presented with increased cytokine levels at birth, this abnormality persisted throughout the infectious process.