P2C249: Red Blood Cell Distribution Width (RDW) and Mean Platelet Volume (MPV) as Predictive Markers in Late Onset Neonatal Sepsis in Preterm Infants

Background: In preterm infants, late onset sepsis (LOS) remains a leading cause of neonatal morbidity and mortality [1]. LOS has been associated with prolonged hospitalization, development of bronchopulmonary dysplasia and poor neurodevelopmental outcome [2–4]. Early diagnosis remains a challenge due to nonspecific initial symptoms, which requires more efficient laboratory tests. Recent studies described RDW and MPV as convenient and rapid diagnostic markers of neonatal sepsis [5–9]. RDW is related to an increased rate of mortality [10] and varied significantly with the severity of neonatal sepsis [11]. MPV was reported significantly higher in the neonatal sepsis group compared with the control group [12]. Studies about the association between RDW and late onset sepsis are limited. Therefore, we aim to investigate the potential role of RDW and MPV in early diagnosis and prognosis of late onset sepsis.

Methods: This is a case control study design that included 66 neonates who were admitted to NICU at Brookdale Hospital for more than 5 days between Jan 2018 and June 2022. Neonates with perinatal asphyxia, meconium aspiration syndrome (MAS), congenital malformations, congenital infections, metabolic disease, Rh or ABO isoimmunization were excluded. We selected neonates with late onset sepsis who met our inclusion criteria and control group who were admitted to NICU for more than 5 days and had more than two CBCs. We used an independent t-test between the late onset sepsis group (LOS) and control group to compare the mean values of RDW and MPV before LOS and after antibiotic (in non-LOS group, we used CBC at day 5 and near the end of neonatal period).

Results: A total of 66 premature babies met inclusion criteria. Table 1 summarizes patient characteristics. RDW in LOS group [M=18.721 and SD=3.2236] is higher than in non-LOS group (M=16.283 and SD=1.0527); t(64)= -4.519, p= < 0.001. MPV in LOS group [M=10.521 and SD=1.4967] is higher than in non-LOS group (M=9.036 and SD=1.0453); t(64)= -4.731, p= < 0.001. Since RDW can increase due to transfusion [13], we sub-divided them into transfusion and non-transfusion group. [10] We find that there is no more significant difference in RDW and MPV between transfusion and non-transfusion group.

Conclusion: RDW and MPV increase among preterm neonate with late onset sepsis.