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conferenceseries
.com
Volume 04
Journal of Neonatal & Pediatric Medicine
Neonatal Nursing Congress 2018
May 14-15, 2018
May 14-15, 2018 Singapore
30
th
Global Experts Meeting on
Neonatal Nursing &
Maternal Healthcare
Optimizing the umbilical cord: Identifying cord blood neutropenia to help predict early onset sepsis
Victoria Mattox
Valley Children's Healthcare & Hospital, USA
Statement of the Problem:
Early Onset Sepsis (EOS) in newborns can be hard to identify due to multiple contributing factors
and a lack of early reliable markers that allow for definite identification. Clinicians depend on determining whether risk factors
such as prematurity, Prolonged Rupture Of Membranes (PROM), under treatment for GBS positive or unknown mothers and
chorioamnionitis are present to help determine if there is a need to evaluate and treat sepsis prospectively. The identification
of cord blood neutropenia has been introduced as an independent and adjunct marker to help identify EOS. The purpose of
this study was to establish reference values for cord blood neutrophil counts per gestational age and to look at the sensitivity,
specificity and favorable likelihood ratio of cord neutropenia as an independent marker and as an adjunct marker to detect
EOS in newborns >34 weeks’ gestational age.
Methodology &Theoretical Orientation:
This study was done in a retrospect. A cohort was identified and included mother-
infant pairs that experienced singleton deliveries between 2009 and 2014 at Centre Hospitalier Universitaire de Sherbrooke
(Quebec, Canada). Each mother-infant pair that was included had cord blood neutrophil counts recorded. A standard criterion
was used by the clinicians to identify EOS cases from the sample by examining medical records. Diagnostic values were fixed
for neutropenia per gestational age. Finally, a nested case-control design was utilized to quantify the worth of neutropenia in
the detection of EOS independently and along-side other known risk factors.
Findings:
The cohort identified included 8,590 mother-infant pairs. There were 84 sepsis cases identified. Neutrophil counts
were closely related to gestational age and when neutropenia was adjusted for gestational age, there was good specificity but
poor sensitivity. Cord blood neutropenia as an adjunct to other EOS risk factors revealed an increase in sensitivity without
decreasing specificity.
Conclusion & Significance:
Cord blood neutropenia adjusted for gestational age is remarkably associated with EOS and the
addition of neutropenia to established risk factors for sepsis does increase the rate of detection of EOS.
victoriamattox19@gmail.comNeonat Pediatr Med 2018, Volume 4
DOI: 10.4172/2572-4983-C1-003