[Evaluation of diagnostic usefulness of the cord blood TNF-alpha levels as a marker of early onset neonatal infection].
OBJECTIVE
The aim of the study was to assess whether cord blood TNF-alpha levels can be useful as a marker of early onset neonatal infection.


METHODS
A prospective survey of a group of 110 newborns performed during the first 3 days of life.


METHODS
The study was performed on a group of 110 newborns. In all the examined babies, cord blood TNF-alpha levels was evaluated by RIA. In addition CRP levels, and WBC, RBC, PLT were determined during the first two hours of life. On the basis of clinical symptoms and results of the known laboratory markers of infection the examined babies were divided into two subgroups. 74 of them were a study group and the other 36 -control group.


RESULTS
It was found that cord blood TNF-alpha levels were significantly higher (p < 0.05) in the study than in the control group [Me = 31.15 pg/ml (5.0-311.0) versus Me = 21.4 pg/ml (5.0-74.8)]. The differentiation level of the TNF-alpha between study and control group was assessed on the level of 15 pg/ml. It was found that the sensitivity of this test as a marker of early onset infection is 78.0% and specificity is only 41.2%; odds ratio--3.2. Furthermore we did not find a significant correlation between TNF-alpha levels and CRP, as well as WBC, RBC ant PLT count.


CONCLUSIONS
Newborns developing early onset infection are born with higher TNF-alpha levels than healthy subjects are. Low specificity of this test despite high sensitivity is a reason, which can cause a limitation in using this test in clinical practice.
Kowalik
Kinga
K
Czeszyńska
Maria Beata
MB
Celewicz
Zbigniew
Z
D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005069:Evaluation Studies as Topic; D005260:Female; D005312:Fetal Blood; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha