Comparative Study of Umbilical Cord Blood versus Peripheral Venous Blood in Early-onset Neonatal Sepsis in a Tertiary Hospital

A BSTRACT Background: Neonatal morbidity and mortality continue to be significantly impacted by early-onset sepsis. Blood culture remains the diagnostic gold standard, but obtaining adequate peripheral blood is challenging in neonates. Objective: To compare the yield and concordance of umbilical cord blood culture with peripheral venous blood culture for early detection of early-onset neonatal sepsis in neonates with predefined maternal and neonatal risk factors. Materials and Methods: A prospective observational study was conducted on 242 neonates with early–onset neonatal sepsis (EONS) risk factors. Cord blood was collected within 10 min postdelivery, and peripheral blood was collected 30 min post-delivery for culture and C-reactive protein (CRP) analysis. Diagnostic accuracy, sensitivity, specificity and correlation with clinical sepsis were calculated. Results: Among 242 neonates, 56.6% were male and 43.4% female. Birth asphyxia (38%) and maternal fever (29.7%) were the most common risk factors. The sepsis screen was positive in 27.2% of neonates. Cord blood culture was positive in 26.8% and peripheral culture in 28.1%. The sensitivity and specificity of cord culture were 73.5% and 90.8%, respectively. CRP at a cut-off of 9 mg/L had 41% sensitivity and 83% specificity. Overall, 87.6% of neonates were discharged, 5.7% died and 6.6% left against medical advice. Conclusion: Umbilical cord blood sampling is a less invasive and feasible option for early evaluation of neonatal sepsis, especially when peripheral venous access is difficult. While specificity is good, limited sensitivity suggests it should complement, not replace, standard diagnostic methods. Larger multicentre studies are required for validation.