Diagnostic Accuracy of Haematological Scoring System in Paired cord Blood and Peripheral Venous Blood for early Detection of Neonatal Sepsis – A Prospective Analytical Study

Introduction: Sepsis is one of the major causes of neonatal morbidity and mortality. Early recognition and diagnosis of early onset neonatal sepsis (EONS) is difficult. Hence, there is a need for early predictive screening method for EONS, for which Haematological Scoring System (HSS) is used. It comprises of total leucocyte count, immature / total neutrophil ratio, total PMN count, immature PMN count, degenerative changes in PMN and platelet count. Methods: 100 inborn neonates with two or more risk factors for EONS, chosen by sequential sampling method were included in this prospective analytical study. Blood samples were collected from umbilical cord and peripheral vein and analysed for haematological parameters. Blood cultures were performed as gold standard for diagnosing neonatal sepsis and sepsis screen was done to corroborate the diagnosis of EONS. Results: Out of 100 neonates, 21 had sepsis, 14 had probable sepsis and 65 had no sepsis. Among the variables of HSS it was observed that elevated I:T ratio, thrombocytopenia, elevated I:M ratio and elevated immature neutrophil count have shown significant correlation with EONS with statistically significant p values (p value < 0.05), with raised I:T ratio being highly sensitive in identifying neonatal sepsis and degenerative changes in neutrophils being highly specific. Conclusions: The HSS was found to be satisfactory in identifying EONS. It can be used as a simple, quick, cost effective and readily available screening test with decent sensitivity and high specificity, for detection of EONS.