The validity of the hematologic scoring system in diagnosing early-onset neonatal infection
Early diagnosis and treatment of the neonate with suspected infection are essential to prevent severe and life-threatening complications. The aim of this retrospective study was to evaluate the validity of the hematologic scoring system in diagnosing earlyonset neonatal infection (EONI), according to Rodwell et al. We included 341 term singletons of both genders, gestational age of 37th to 42nd week, with risk factors for EONI and without visible anomalies. A diagnosis of EONI was based on clinical, laboratory and/or microbiological findings of EONI, without consideration of hematologic findings. Hematologic findings (white blood with differential count, and platelets count) were scored according to Rodwell et al. The cut-off score was 3. During the study period, there were 12 298 live births, 11 599 terms and 699 prematures. In the first 72 hours of life, 199/341 (58.4%) neonates were considered to have EONI, of which 52/199 (26.1%) neonates with proven and 73.9% probable EONI. The applied hematologic scoring systems in EONI had high specificity (92%) and positive predictive value (PPV) (88%), as same as in probable EONI with specificity of 92% and PPV of 84%. In proven EONI both specificity (92%) and negative predictive value PPV (82%) were high. The validity of the hematologic scoring system in diagnosing EONI among neonates with risk factors is acceptable. The use of the test is available even in the smallest delivery rooms, and the price is reasonable, not only for single but for repeated use.