|
Investigations |
No. of positive cases |
Percentage |
||
Cord blood |
At 24 hrs |
Cord blood |
At 24 hrs |
||
1 |
CRP >6mg/L |
20 |
170 |
6.7 |
57 |
2 |
TLC<5000/cu.mm
|
4 |
8 |
2.7 |
1.3 |
3 |
ANC<1500/cu.mm |
8 |
7 |
2.7 |
2.4 |
4 |
I/T ratio>0.2 |
7 |
8 |
2.4 |
2.7 |
|
Sensitivity |
Specificity |
PPV |
NPV |
At 24 hrs |
||||
CRP ≥6 mg/L |
93.3% |
44.9% |
8.2% |
99.2% |
CRP ≥12mg/L |
40.0% |
80.6% |
9.8% |
96.2% |
At 48 hrs |
||||
CRP ≥6mg/L |
66.7% |
68.2% |
10.0% |
97.5% |
CRP ≥12mg/L |
20.0% |
86.6% |
7.3% |
95.3% |
CRP
Levels(mg/dl) |
Proven
Sepsis |
Probable
Sepsis |
No sepsis |
P value |
Cord blood < 6 u |
||||
<6 |
0 |
3(1.08%) |
179(64.4%) |
0.009 |
≥6 |
5(1.79%) |
1(0.36%) |
50(17.9%) |
0.01 |
>12 |
1(0.36%) |
1(0.36%) |
38(13.7%) |
0.66 |
Cord blood > 6 |
||||
<6 |
0 |
2(10%) |
14(70%) |
0.16 |
≥6 |
0 |
1(5%) |
2(10%) |
0.50 |
>12 |
1(5%) |
0 |
0 |
0.20 |
|
Sensitivity |
Specificity |
PPV |
NPV |
At 24 hrs |
||||
CRP ≥6 mg/L |
93.3% |
44.9% |
8.2% |
99.2% |
CRP ≥12mg/L |
40.0% |
80.6% |
9.8% |
96.2% |
At 48 hrs |
||||
CRP ≥6mg/L |
66.7% |
68.2% |
10.0% |
97.5% |
CRP ≥12mg/L |
20.0% |
86.6% |
7.3% |
95.3% |
Risk
factors |
Number of cases observed |
CRP (mg/L) |
Risk ratio (95%CI) |
||||
Cord Blood (≥6 mg/L) (n=20) |
Neonatal Blood (≥6 mg/L) (n=109) |
Neonatal Blood (>12 mg/L) (n=61) |
Cord Blood (≥6 mg/L) |
Neonatal Blood (≥6 mg/L) |
Neonatal Blood (>12mg/L) |
||
Primipara |
170 |
6 (30%) |
81 (74.3%) |
25 (40.9%) |
0.32 (0.12 to 0.81) |
2.17* (1.51 to 3.13) |
0.52 (0.33 to 0.82) |
Male |
188 |
7 (35%) |
75 (68.8%) |
40 (65.6%) |
0.31 (0.12to 0.76) |
1.29 (0.92 to 1.79) |
1.11 (0.69 to 1.78) |
SVD |
169 |
3 (15%) |
67 (61.5%) |
28 (45.9%) |
0.13 (0.04 to 0.45) |
1.21 (0.89 to 1.66) |
0.64 (0.41 to 1.01) |
Gestation <37wks |
50 |
2 (10%) |
13 (11.9%) |
6 (9.8%) |
0.55 (0.13 to 2.30) |
0.67 (0.41 to 1.10) |
0.54 (0.25 to 1.20) |
ROM < 18 hrs |
62 |
3 (15%) |
18 (16.5%) |
7 (10.4%) |
0.67 (0.20 to 2.2) |
0.75 (0.49 to 1.14) |
0.47 (0.22 to 0.98) |
ROM 18-24 hrs |
193 |
7 (35%) |
90 (82.6%) |
41 (67.2%) |
0.29 (0.12 to 0.71) |
2.57* (1.66 to 3.97) |
1.11 (0.69 to 1.80) |
ROM >24
hrs |
43 |
11 (55%) |
25 (22.9%) |
14 (22.9%) |
7.53* (3.31 to 17.1) |
1.76* (1.29 to 2.40) |
1.76* (1.06 to 2.91) |
Prolonged labour |
91 |
16 (80%) |
35 (32.1%) |
21 (34.4%) |
9.09* (3.12 to 26.4) |
1.07 (0.78 to 1.47) |
1.19 (0.74 to 1.90) |
Maternal fever |
30 |
10 (50%) |
22 (20.1%) |
9 (14.8%) |
8.93* (4.04 to 19.7) |
2.25* (1.71 to 2.97) |
1.54 (0.84 to 2.81) |
>3VE after ROM |
143 |
6 (30%) |
70 (64.2%) |
31 (50.8%) |
0.46 (0.18 to 1.17) |
2.28* (1.70 to 3.06) |
1.12 (0.71 to 1.75) |
FSL |
22 |
3 (15%) |
8 (7.3%) |
1 (1.6%) |
2.21 (0.70 to 6.98) |
0.97 (0.55 to 1.73) |
0.20 (0.03 to 1.43) |
MSL |
104 |
4 (20%) |
60 (55.0%) |
15 (24.6%) |
0.46 (0.16 to 1.35) |
2.28* (1.70 to 3.06) |
0.60 (0.35 to 1.03) |
Sl. No |
Screening parameters |
Culture positives n = 7 (%) |
Culture negative n =8 (%) |
Total cases n = 15 |
P- value |
1 |
CRP positive |
7(100%) |
7(87.5%) |
14(93.3%) |
1.0000 |
2 |
Leucopenia (<5000/cmm) |
3(42.9%) |
1(12.5%) |
4(26.7%) |
0.2821 |
3 |
Neutropenia (<1500/cmm) |
6(85.7%) |
1(12.5%) |
7(46.7%) |
0.0101 |
4 |
I/T ratio > 0.2 |
6(85.7%) |
2(25%) |
8(53.3%) |
0.0406 |
5 |
Two or more tests positive |
7(100%) |
1(12.5%) |
8(53.3%) |
0.0014 |
Risk factor’s |
No. of Cases observed |
Present Study CRP (mg/dl) |
Risk
ratio(95%CI) |
No. of Cases observed |
Mathai et al[25] CRP (mg/dl) |
Risk
ratio(95%CI) |
||||
Cord Blood (6mg/L) (n=20) |
Neonatal Blood (≥6 mg/L) (n=109) |
Neonatal Blood (>12 mg/L) (n=61) |
Cordmkkk9 Blood (6 mg/L) (n=7) |
Neonatal Blood (≥6 mg/L) (n=102) |
Neonatal Blood (>12 mg/L) (n=48) |
|||||
Primiparity |
170 |
6 |
81* |
25 |
2.17* |
164 |
6 |
77* |
32 |
*1.62 |
ROM < 18 hrs |
62 |
3 |
18 |
7 |
|
58 |
1 |
20 |
11 |
|
ROM 18-24 hrs |
193 |
7 |
90* |
41 |
2.57* |
192 |
6 |
82 |
37 |
|
ROM >24 hrs |
43 |
11* |
25* |
14* |
7.53*,
1.76*, 1.76* |
75 |
5* |
30 |
16 |
*5.83 |
Prolonged labour |
91 |
16* |
35 |
21 |
9.09* |
103 |
7* |
47 |
26* |
*1.69 |
Maternal fever |
30 |
10* |
22* |
9 |
8.93*, 2.25* |
22 |
3* |
11 |
8* |
*7.77 *2.07 |
>3VE after ROM |
143 |
6 |
70* |
31 |
2.28* |
114 |
5 |
56* |
27 |
*1.45 |
FSL |
22 |
3 |
8 |
1 |
|
6 |
1 |
4 |
2 |
|
MSL |
104 |
4 |
60* |
15 |
2.28* |
50 |
2 |
28* |
13 |
*1.51 |
Gestation <37wks |
50 |
2 |
13 |
6 |
|
32 |
1 |
9 |
4 |
|
Male |
188 |
7 |
75 |
40 |
|
142 |
6 |
56 |
25 |
|
SVD |
169 |
3 |
67 |
28 |
|
134 |
1 |
50 |
21 |
|
Authors |
Sensitivity |
Specificity |
PPV |
NPV |
Mathai et al[25] |
80% |
60% |
7.7% |
98.6% |
K Swarnkar et al[27] |
52.3% |
56%, |
89% |
14.3% |
Varsha et al[28] |
60% |
88.2% |
33% |
95.7% |
Twinkle N Gandhi et al[29].
|
100% |
75% |
77% |
100% |
Jan AZ et
al.[30] |
88.4% |
89.1% |
90.5% |
86.7% |
Sucilathangam G. et al[31] |
50.0 % |
69.4 % |
38.8 % |
78.1 %. |
Gerdes et al[32] |
70%-93% |
78%-94% |
7%-43% |
97- 99 % |
Present study |
93.3% |
44.9% |
8.2% |
99.2% |