Publication:

Relationship between maternal C-reactive protein, cord blood C-reactive protein and early onset neonatal sepsis in a tertiary care centre in North Kerala

Background Early-onset neonatal sepsis (EONS) remains a major cause of neonatal morbidity and mortality, with diagnosis often delayed due to non-specific presentation. Maternal and neonatal inflammatory markers such as C-reactive protein (CRP) have been explored as early predictors of infection. Objectives were to determine the relationship between maternal CRP, cord blood CRP, and EONS in high-risk mothers, and to evaluate the diagnostic performance of these markers.

Methods This prospective observational study included 96 high-risk mothers and their neonates at Malabar Medical College, Kozhikode. Maternal serum CRP and cord blood CRP were measured, followed by serial neonatal CRP assessments at 24 and 48 hours of life. Blood culture served as the diagnostic gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of maternal and cord blood CRP were calculated.

Results There was no significant association between maternal or cord blood CRP and neonatal sepsis (p>0.05). However, serial CRP at 24 and 48 hours showed significant association with confirmed EONS (p<0.05). Maternal CRP had sensitivity 85.7%, specificity 22.7%, PPV 23.7%, and NPV 85%. Cord CRP showed sensitivity 4.8%, specificity 100%, PPV 100%, and NPV 78.9%.

Conclusions Maternal and cord CRP alone are not reliable indicators of early-onset sepsis, but serial neonatal CRP monitoring at 24-48 hours aids in diagnosis. Maternal CRP has good sensitivity and NPV, whereas cord CRP shows high specificity and PPV.