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Cord blood neutropenia is an independent predictor of early sepsis

Journal of Perinatology volume 37, pages 1204–1209 (2017)Cite this article

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Abstract

Objective:

The significance of cord blood neutropenia as a screening tool for early-onset sepsis (EOS) is unclear. The objectives were to define reference values for cord blood neutrophil count and to determine the sensitivity and positive likelihood ratio of cord neutropenia for the detection of EOS.

Study Design:

This retrospective observational cohort study included all mother–infant pairs with deliveries between 2009 and 2014 for whom cord neutrophil counts were routinely done. EOS cases were identified by interrogation of electronic charts. Maternal and perinatal factors were assessed to determine reference values of cord neutrophil. The diagnostic value of neutropenia for detecting EOS was assessed. A nested case–control design was used to measure the value of neutropenia in the detection of EOS in comparison with other risk factors.

Results:

A total of 8,590 mother–infant pairs were included. We identified 84 sepsis cases. The neutrophil count was strongly associated with gestational age. Neutropenia adjusted for gestational age was strongly associated with EOS and had good specificity but poor sensitivity. The addition of neutropenia to other EOS risk factors increased sensitivity without decreasing specificity.

Conclusion:

Cord blood neutropenia was significantly associated with EOS and the addition of cord neutropenia to current EOS risk factors increased the detection rate of EOS.

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Acknowledgements

We thank Dr Arnaud Gagneur and Dr Celine Catelin for reviewing non-consensual sepsis cases. FD is supported in part by the Fonds de Recherche du Québec—Santé.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine and Health Sciences, Centre de recherche du Centre hospitalier universitaire de Sherbrooke and University of Sherbrooke, Sherbrooke, QC, Canada

    E Beaulieu, E Massé & F Dallaire

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  1. E Beaulieu
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  2. E Massé
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  3. F Dallaire
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Correspondence to F Dallaire.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Beaulieu, E., Massé, E. & Dallaire, F. Cord blood neutropenia is an independent predictor of early sepsis. J Perinatol 37, 1204–1209 (2017). https://doi.org/10.1038/jp.2017.115

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