Clinical Significance of Red Cell Distribution Width as an Early Prognostic Marker in Early Onset Neonatal Sepsis

Abstract

Objective: This study aimed to assess the diagnostic and prognostic value of red cell distribution width (RDW), an easily available parameter from complete blood count, in neonates with suspected early-onset neonatal sepsis (EONS).

Methodology:

A prospective observational study was carried out over six months in the Neonatal Intensive Care Unit (NICU) of a tertiary-care hospital. A total of 127 term neonates presenting within 72 hours of life with suspicion of EONS were included. RDW was measured within 12 hours of admission and blood cultures were obtained. According to the outcome of the cultures, the neonates were categorized into septic and non-septic. Prognostic evaluation was carried out by comparing RDW values between groups and comparing them to ventilatory support, mortality and length of NICU stay. The analysis of data was performed using SPSS software version 25 and the p value of 0.05 was regarded as statistically significant.

Results:

A total of 127 neonates with a mean gestational age of 38.2±0.8 weeks were included. Of these, 20.5% (n=26) had culture-proven EONS. Mean RDW was higher in septic neonates compared to non-septic neonates (16.9 ± 3.8% vs 11.6 ± 4.2%, p-value=0.183), this difference was not statistically significant. A raised RDW was corelated with prolonged NICU stay (p=0.033) and increased ventilatory support (p=0.24).

Conclusion:

RDW itself does not appear to be a reliable marker for diagnosing neonatal sepsis however, high RDW was associated with poor clinical outcomes, indicating that it may serve as a useful prognostic marker than a diagnostic one in case of suspected EONS.

Keywords: Neonatal sepsis, Early-Onset Neonatal Sepsis, Red Cell Distribution Width, Prognostic markers, Inflammatory Biomarkers.