Diagnostic Role of Serum Haptoglobin level in Early Onset Neonatal Sepsis

Document Type : Original Article

Authors

1 Pediatrician, Department of neonatology and pediatrics, school of medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.

2 Department of neonatology Akbarabadi Hospital, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran.

Abstract

Background: Introduction: Searching for an ideal marker for diagnosing neonatal infection is still an important concern in every country. There are many biomarkers reported for neonatal sepsis. Haptoglobin is an acute phase reactants which rise in response to infection and injuries. In this report we discussed the efficacy of serum haptoglobin level in different cut off levels in early onset neonatal sepsis.
Material and methods: Total of 84 neonates divided in to a sepsis (43 neonates) and control group (41 neonates) and enrolled in this case-control study. Sepsis was defined base on both clinical and laboratory criteria. Serum haptoglobin level was evaluated in both groups. Sensitivity and specificity of haptoglobin in different cut off points was evaluated and study data was analyzed by SPSS 18 software.
Results:Neonates in both groups didn’t have significant relation in term of gender, gestational age at birth and birth weight. Serum level of haptoglobin in sepsis group was significantly higher than control group (P=0.0001). Also there was significant relation between haptoglobin and positive blood cultures (p=0.0001). Cut of point of 25mg/dl had sensitivity of 67%, specificity of 95%, accuracy of 80% and positive predictive value of 93% and considered as preferable cut off point in early neonatal sepsis.
Conclusion: Serum plasma haptoglobin can be a specific diagnostic factor in diagnosing early neonatal sepsis in keeping with other diagnostic tests for sepsis.
 

Keywords


  1. Lawn JE, Osrin D, Adler A, Cousens S. Four million neonatal deaths: counting and attribution of cause of death. Paediatric and perinatal epidemiology. 2008;22(5):410-6.
  2. Chiesa C, Panero A, Osborn JF, Simonetti AF, Pacifico L. Diagnosis of neonatal sepsis: a clinical and laboratory challenge. Clin Chem. 2004;50(2):279-87.
  3. Kale A, jaybhaye D, Bonde V. Neonatal Sepsis: An Update. Iranian Journal of Neonatology IJN. 2013;4(4):39-51.
  4. Kasvosve I, Speeckaert MM, Speeckaert R, Masukume G, Delanghe JR. Haptoglobin polymorphism and infection. Advances in clinical chemistry. 2010;50:23-46.
  5. Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatric clinics of North America. 2013;60(2):367-89.
  6. Hornik CP, Benjamin DK, Becker KC, Benjamin DK, Li J, Clark RH, et al. Use of the Complete Blood Cell Count in Early-Onset Neonatal Sepsis. The Pediatric Infectious Disease Journal. 2012;31(8):799-802.
  7. Yao Y, Tu Y, Lu Q. [Values of C-reactive protein, percentage of neutrophils and mean platelet volume in early diagnosis of neonatal sepsis]. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics. 2015;17(5):425-9.
  8. Zareifar S, Pishva N, Farahmandfar M, Benaei S, Cohan N. Prevalence of G6PD Deficiency in Neonatal Sepsis in Iran. Iranian Journal of Pediatrics. 2014;24(1):115-6.
  9. Alexander Kratz EL-L, Kent B.Lewandrowski. The Plasma Proteins. In: McClatchey KD, editor. Clinical laboratory medicine. 2nd ed: Lippincott Williams & Wilkins; 2002. p. 272.
  10. KALAYCI AG, YILMAZER F, ADAM B, SANCAK R, KÜÇÜKÖDÜK Ş. The importance of fibronectin, haptoglobin, ceruloplasmin and transferrin in the early diagnosis of neonatal sepsis. Turkish Journal of Medical Sciences. 2000;30(2):151-6.
  11. Bhandari V. Effective Biomarkers for Diagnosis of Neonatal Sepsis. Journal of the Pediatric Infectious Diseases Society. 2014;3(3):234-45.
  12. Zhao FX, Liu GH, Zhang J. [Value of IL-6 and IL-8 in the diagnosis of neonatal sepsis]. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics. 2015;17(12):1311-5.
  13. Singh Laishram R, Devi Khuraijam R. Hematological and Biological Markers of Neonatal Sepsis. Iranian Journal of Pathology. 2013;8(3):137-46.
  14. Chavez-Bueno S, Beasley JA, Goldbeck JM, Bright BC, Morton DJ, Whitby PW, et al. 'Haptoglobin concentrations in preterm and term newborns'. Journal of perinatology : official journal of the California Perinatal Association. 2011;31(7):500-3.
  15. Khair KB, Rahman MA, Sultana T, Roy CK, Rahman MQ, Ahmed AN. Early diagnosis of neonatal septicemia by hematologic scoring system, C-reactive protein and serum haptoglobin. Mymensingh medical journal : MMJ. 2012;21(1):85-92.