title: Proadrenomedullin as a prognostic marker in neonatal sepsis.
abstract: BACKGROUND
  Proadrenomedullin (pro-ADM) for the diagnosis of proven and clinical sepsis in a newborn cohort including preterm newborns has not been investigated. We aimed to investigate the value of pro-ADM as a new marker by comparing it with conventional markers in neonatal sepsis (NS).
  
  
  METHODS
  Participants were stratified into three groups; proven sepsis (Group 1a), clinical sepsis (Group 1b), and the control group (Group 2), which consisted of newborns of matched gestational age and birth weight. Sequential measurements of white blood cell count, C-reactive protein (CRP), interleukin-6 (IL-6), and pro-ADM were compared.
  
  
  RESULTS
  A total of 76 patients with NS (31 with proven sepsis and 45 with clinical sepsis) and 52 healthy controls were enrolled. Mean baseline serum levels of CRP, IL-6, and pro-ADM were significantly higher in both Group 1a and Group 1b as compared with healthy controls (P < 0.001 for both). Although mean baseline CRP and IL-6 levels were similar between groups, mean baseline pro-ADM level was higher in the proven sepsis group than in the clinical sepsis group (P < 0.001).
  
  
  CONCLUSIONS
  The use of pro-ADM in combination with other acute-phase reactants such as CRP and IL-6 for the diagnosis and follow-up of patients with NS has high sensitivity and specificity.
authors.affiliation: Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
authors.forename: Mehmet Yekta
authors.initials: MY
authors.lastname: Oncel
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Ramazan
authors.initials: R
authors.lastname: Ozdemir
authors.forename: Erhan
authors.initials: E
authors.lastname: Calisici
authors.forename: Sadik
authors.initials: S
authors.lastname: Yurttutan
authors.forename: Fuat Emre
authors.initials: FE
authors.lastname: Canpolat
authors.forename: Serife Suna
authors.initials: SS
authors.lastname: Oguz
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D013997:Time Factors; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D011498:Protein Precursors; C088633:proadrenomedullin; D053607:Adrenomedullin; D002097:C-Reactive Protein