Neonatal positivity of CRP test in early onset neoanatal sepsis in relation to duration of PROM vs PROM delivery Interval (PDI)

To know, which one, PROM duration or PDI is in high risk for CRP positive early onset neonatal sepsis to start antibiotic in treatment to prevent perinatal morbidity and mortality.

Total 150 newborn cases admitted to NICU, diagnosed as EONS associated with their maternal history PROM were taken. The information in all the neonate, enrolled into the study as sex, gestational age, weight, with maternal duration of PROM and PROM delivery interval were recorded. In all the cases CRP was done by latex agglutination test and blood culture was sent to confirm sepsis.

There were 40% cases of CRP positivity in EONS with 6 hour of PROM in comparison to 63% positivity associated with PDI of 12 hour duration. CRP was positive in all cases that presented beyond 24 hour of rupture of membrane. The risk of developing EONS was higher (100%) in cases that delivered beyond 24 hours of PDI compared to the cases that delivered within 24 hours. There was a statistical significant relationship of CRP with PROM and PDI (P value-<0.05).

Preventive measures should focus on recognition of factor according to the risk, such as PROM even if 6 hour is high for neonate, PDI should be considered first, with prompt laboratory screening for sepsis. Early institution of empirical antibiotic in treatment to prevent need for neonatal intensive care without increase in perinatal morbidity and mortality.