Alma Patricia González, Laura Irandeni Acuña-Cenoz, Martha Daniela Alcázar-Olaiz, Pablo Fabián Estevez-Alemán, Carlos Paque-Bautista, Gloria Patricia Sosa-Bustamante
{"title":"[Inflammatory and clinical markers predicting mortality in neonates under 1500 g].","authors":"Alma Patricia González, Laura Irandeni Acuña-Cenoz, Martha Daniela Alcázar-Olaiz, Pablo Fabián Estevez-Alemán, Carlos Paque-Bautista, Gloria Patricia Sosa-Bustamante","doi":"10.5281/zenodo.15178474","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early neonatal mortality occurs within 7 days of life. Clinical variables, inflammatory markers and CRIB (Clinical Risk Index for Babies) could be useful to identify mortality risk.</p><p><strong>Objective: </strong>To assess the predictive value of inflammatory and clinical markers for early mortality in preterm newborns (PTNB) < 1500 g.</p><p><strong>Material and methods: </strong>Analytical, retroprospective, observational and cross-sectional study. PTNBs with birth weight < 1500 g were included. Clinical characteristics, CRIB, inflammatory markers and C-reactive protein (CRP) were evaluated at 12 hours of life.</p><p><strong>Results: </strong>248 PTNBs were studied, with a gestational age of 32 weeks (IQR 30-34), weight 1285 g (IQR 1070-1400); 20 died (8.06%). Risk factors for mortality were weight ≤ 1000 g, OR = 24 (7.69-77.96), p < 0.0001; gestational age ≤ 28 weeks, OR = 42 (13.71-128.61), p < 0.0001; invasive ventilation, OR = 44.7 (5.85-340), p < 0.0001. Protective factors were antenatal corticosteroids, OR = 0.15 (0.05-0.39), p = 0.0001, and maternal preeclampsia, OR = 0.13 (0.01-1.02), p = 0.01. CRP, base deficit and birth weight were associated with mortality in the multivariate analysis (intercept = 6.62; SE = 1.85; R2 = 0.60; p = 0.0003). CRP ≥ 2.30 µg/dL showed a sensitivity of 26.32% and a specificity of 97.50% for mortality, AUC = 0.69, p = 0.005.</p><p><strong>Conclusions: </strong>Predictors of early mortality were weight ≤ 1000 g, gestational age ≤ 28 weeks and CRP ≥ 2.30 μg/dL.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"63 3","pages":"e6488"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista medica del Instituto Mexicano del Seguro Social","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5281/zenodo.15178474","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Early neonatal mortality occurs within 7 days of life. Clinical variables, inflammatory markers and CRIB (Clinical Risk Index for Babies) could be useful to identify mortality risk.
Objective: To assess the predictive value of inflammatory and clinical markers for early mortality in preterm newborns (PTNB) < 1500 g.
Material and methods: Analytical, retroprospective, observational and cross-sectional study. PTNBs with birth weight < 1500 g were included. Clinical characteristics, CRIB, inflammatory markers and C-reactive protein (CRP) were evaluated at 12 hours of life.
Results: 248 PTNBs were studied, with a gestational age of 32 weeks (IQR 30-34), weight 1285 g (IQR 1070-1400); 20 died (8.06%). Risk factors for mortality were weight ≤ 1000 g, OR = 24 (7.69-77.96), p < 0.0001; gestational age ≤ 28 weeks, OR = 42 (13.71-128.61), p < 0.0001; invasive ventilation, OR = 44.7 (5.85-340), p < 0.0001. Protective factors were antenatal corticosteroids, OR = 0.15 (0.05-0.39), p = 0.0001, and maternal preeclampsia, OR = 0.13 (0.01-1.02), p = 0.01. CRP, base deficit and birth weight were associated with mortality in the multivariate analysis (intercept = 6.62; SE = 1.85; R2 = 0.60; p = 0.0003). CRP ≥ 2.30 µg/dL showed a sensitivity of 26.32% and a specificity of 97.50% for mortality, AUC = 0.69, p = 0.005.
Conclusions: Predictors of early mortality were weight ≤ 1000 g, gestational age ≤ 28 weeks and CRP ≥ 2.30 μg/dL.