Hematological Scoring System for Early Diagnosis of Neonatal Sepsis

Background: To determine the accuracy of a simple and cost effective haematological scoring system (HSS) in the early diagnosis of neonatal sepsis using blood culture as a gold standard. Methods: In this prospective cross sectional study newborns (n=170) with history of prolonged rupture of membranes, maternal intrapartum fever > 1010 F or clinical signs of sepsis namely; neonatal fever ≥ 1010 F, poor feeding and lethargy or depressed neonatal reflexes were included in the study. All the newborn babies with history of delayed cry, meconium aspiration, congenital anomaly, history of antibiotics administration prior to admission to the baby or mother, intrapartum and neonatal death in sibling with similar presentation (rule out inborn error of metabolism) were excluded. Patient was scored according to haematological scoring system (HSS), incorporating increase or decrease in leucocytes count, absolute neutrophil count and platelet count. CRP estimation and blood culture were also performed. Score of more than 3 was considered as positive . Results: The mean age of participants was 12.4 ± 7.3 days, of which 54.1% were male. Most neonates(52.4%) were in the age group up to 10 days and 61% were preterm. The HSS was found to have a sensitivity of 90%, specificity of 74.5%, Positive Predictive Value was 65.9% and Negative Predictive Value was 93.2% Conclusion: HSS is a simple cost effective tool to detect neonatal sepsis with high sensitivity and an acceptable specificity.