Diagnosis of early neonatal infections in premature newborns

Objective. To evaluate significance of risk factors, clinical and laboratory indicators in diagnosis of early neonatal infections in premature neonates. Material and methods. A prospective single-center observational study included 385 newborns between 2021 and 2022. Mean gestation period was 35 (33—39) weeks, birth weight — 2500 (1850—3350) g. All children were divided into two groups depending on intraamniotic infection (IAI): group I — IAI, group II — no IAI. All children underwent clinical, laboratory and bacteriological examination within an hour after admission. Negative results of bacteriological examination were registered in 274 (71.4%) children. Among infected cases, Staphylococcus epidermidis (50%) and Klebsiella pneumoniae (14.5%) were the most common. Results. WBC count and neutrophil index were similar in both groups. Significant prognostic factors of early neonatal infection are low birth weight (<2630 g), Apgar score <7 points in the first minute, anhydrous interval >9 hours and serum C-reactive protein >35 mg/l upon admission to ICU. Anhydrous interval >9 hours increases the risk of IAI by 2 times. Conclusion. Analysis of risk factors depending on anhydrous interval and C-reactive protein allows identifying the newborns with high probability of early neonatal infection.