[Inflammatory and clinical markers predicting mortality in neonates under 1500 g].

Revista medica del Instituto Mexicano del Seguro Social Pub Date : 2025-05-02 DOI:10.5281/zenodo.15178474

Alma Patricia González, Laura Irandeni Acuña-Cenoz, Martha Daniela Alcázar-Olaiz, Pablo Fabián Estevez-Alemán, Carlos Paque-Bautista, Gloria Patricia Sosa-Bustamante

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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.

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[炎症和临床指标预测1500克以下新生儿死亡率]。

背景：新生儿早期死亡发生在出生后7天内。临床变量、炎症标志物和婴儿临床风险指数（CRIB）可用于确定死亡风险。目的：探讨炎症及临床指标对< 1500 g早产儿（PTNB）早期死亡的预测价值。材料和方法：分析性、回顾性、观察性和横断面研究。包括出生体重< 1500 g的ptnb。在生命12小时时评估临床特征、CRIB、炎症标志物和c反应蛋白（CRP）。结果：共纳入248例ptnb，胎龄32周（IQR 30-34），体重1285 g (IQR 1070-1400)；死亡20例（8.06%）。死亡危险因素为体重≤1000g， OR = 24 (7.69 ~ 77.96), p < 0.0001；胎龄≤28周，OR = 42 (13.71 ~ 128.61), p < 0.0001；有创通气，OR = 44.7 (5.85-340), p < 0.0001。保护性因素为产前皮质激素，OR = 0.15 (0.05 ~ 0.39), p = 0.0001；孕妇先兆子痫，OR = 0.13 (0.01 ~ 1.02), p = 0.01。在多变量分析中，CRP、基础缺陷和出生体重与死亡率相关(截距= 6.62；Se = 1.85；R2 = 0.60;P = 0.0003)。CRP≥2.30µg/dL对死亡率的敏感性为26.32%，特异性为97.50%,AUC = 0.69, p = 0.005。结论：体重≤1000 g、胎龄≤28周、CRP≥2.30 μg/dL是早期死亡的预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Revista medica del Instituto Mexicano del Seguro Social

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