Abstract
Objective Sepsis is one of the most significant contributors to mortality and morbidity in
the neonatal population. The need to find specific biomarkers that provide meaningful
information about the diagnosis of sepsis is still ongoing. This study aimed to investigate
the utility of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a diagnostic
biomarker in newborn infants with late-onset sepsis.
Methods A prospective, observational study was conducted in the neonatal intensive care unit
between July 2016 and January 2017. The patients suspected of having late-onset sepsis
and meeting the selection criteria were included in the study, and serial measurements
of white blood cell count, serum C-reactive protein (CRP), plasma interleukin (IL)
6, and whole blood NT-proBNP levels were performed.
Results The study included 87 patients diagnosed with sepsis and 35 control patients. The
median NT-proBNP levels were higher in septic patients (58 [22–169] vs. 14 [7–21];
p < 0.001), showing a significant correlation with CRP and IL-6 levels (r = 0.327, p < 0.01 and r = 0.216, p < 0.05, respectively). The optimal diagnostic cutoff value for differentiating sepsis
was 27.5 pg/mL. Predictive parameters of NT-proBNP, such as sensitivity (72%) and
specificity (86%), were comparable to those of CRP and IL-6 for the early diagnosis
of sepsis in neonates.
Conclusion Plasma NT-proBNP levels were higher in septic neonates, and the predictive values
were comparable to those of CRP and IL-6. However, these values were not high enough
to make it a reliable diagnostic biomarker for identifying neonates in the early stages
of sepsis.
Keywords
preterm - sepsis - proBNP
