Study of interleukin-6 levels in early diagnosis of neonatal sepsis

Background:Neonatal septicemia is one of the commonest causes of neonatal mortality and morbidity. Interleukin-6 Levels appears to be one of the most promising candidate cytokine for early diagnosis of neonatal septicaemia. The aim and objectives of this study was to study the role of IL-6 levels as an early marker for diagnosis of neonatal sepsis and to compare IL-6 levels with other septic markers.  Methods:This is a hospital based prospective study to evaluate the efficacy of IL-6 as an early diagnostic marker of neonatal sepsis. Eighty neonates, delivered in the hospital, having risk factors for neonatal sepsis, along with those coming to hospital with signs and symptoms of sepsis up to 28 days of life (as study group ) along with normal new-borns admitted to the postnatal ward without high risk factors (control group) were enrolled for this study.Results:IL-6 Levels has shown maximum sensitivity of 95.83%, specificity of 87.50%, positive predictive value of 92%, negative predictive value of 93.33% and accuracy of 92.50 %. E. coli was the most common organism responsible for sepsis. CRP was reported to be highly sensitive (84.21%), and  CBC was highly specific (75.00%), IT ratio has sensitivity of 62.5% and specificity of 56.25% while micro-ESR has shown sensitivity of 50.0% and specificity of 62.5%. Out of 80 cases, blood culture (BacTalert) showed growth in 48 cases in study group while two cases in control group. Thus blood culture positivity was 60%.Conclusion:IL-6 test has maximum sensitivity as well as specificity in comparison with other septic markers. Blood culture is the gold standard for the diagnosis of septicemia. CRP is most sensitive while CBC is most specific marker in neonatal sepsis.

Association of Maternal Factors with hyperbilirubinaemia in Newborns at a Tertiary Care Hospital in Navi Mumbai, India: A Cross-sectional Study

Introduction: Hyperbilirubinaemia in newborns is a common and serious condition, and it is also one of the most common causes of neonatal readmission to the hospital. It is challenging to diagnose or predict the onset of hyperbilirubinaemia in newborns. Therefore, identifying neonates with maternal risk factors is useful for early prediction of hyperbilirubinaemia, enabling effective management and prevention of complications such as acute bilirubin encephalopathy or kernicterus. Aim: To estimate the prevalence of neonatal hyperbilirubinaemia and its association with various maternal risk factors such as parity, maternal diseases, blood group incompatibility, mode of delivery, etc. Materials and Methods: This hospital-based descriptive, cross-sectional study was conducted at Dr. D.Y. Patil Hospital in Navi Mumbai, Maharashtra, India, from December 2021 to December 2022. A total of 500 healthy full-term neonates and their mothers were screened. Neonates with hyperbilirubinaemia during follow-up were evaluated. Data on maternal factors (e.g., parity, maternal diseases, polyhydramnios, premature rupture of membranes, ABO and Rh incompatibility) were collected, and their association with neonatal hyperbilirubinaemia was assessed. Statistical analysis of the data was performed using the Chi-square test to determine prevalence and significance. Results: Out of the 500 babies studied, 95 had serum total bilirubin levels beyond the acceptable normal level of 13 mg/dL at 72 hours of life. The prevalence of hyperbilirubinaemia was 19%. Among the 95 babies, 40 (42.1%) were born to primigravida mothers, while 55 (57.9%) were born to multigravida mothers. In the present study, the authors observed that out of the 26 mothers suffering from hypothyroidism, 14 babies developed hyperbilirubinaemia. Similarly, out of the 24 mothers with preeclampsia, eight babies developed hyperbilirubinaemia. Furthermore, out of the 15 mothers with diabetes mellitus, six babies developed hyperbilirubinaemia. Additionally, out of the 11 mothers with polyhydramnios, two babies developed hyperbilirubinaemia, and out of the 10 mothers with Premature Rupture of Membranes (PROM), one baby developed hyperbilirubinaemia. Among the 208 male neonates, 58 developed hyperbilirubinaemia, while among the 292 female neonates, 37 developed hyperbilirubinaemia. ABO incompatibility was seen in 23 (24.2%) neonates, and Rh incompatibility was seen in 3 (3.2%) neonates, both of which were identified as important risk factors. A higher incidence of hyperbilirubinaemia was observed in neonates born via Lower Segment Caesarean Section (LSCS) compared to normal vaginal delivery. Conclusion: In the present study, the prevalence of neonatal hyperbilirubinaemia was 19%. Male babies, babies born via LSCS, those with ABO incompatibility, and mothers with hypothyroidism were significantly more prone to develop hyperbilirubinaemia in neonates