title: Bilirubin exposure is associated with neonatal sepsis in the eight days preceding symptoms: a retrospective study.
abstract: OBJECTIVE
  To compare levels of bilirubin (using the area under the curve, AUC) in preterm infants before the onset of sepsis with healthy matched-controls.
  
  
  METHODS
  Preterm infants born between January 2011 and December 2015 with late-onset sepsis were enrolled in our retrospective study and were matched with healthy controls (sex, birth weight and gestational age). Levels of bilirubin were registered in the eight days preceding the onset of sepsis and the AUC was calculated for both groups.
  
  
  RESULTS
  Eighty-eight neonates (44 cases) were studied. GA and BW did not differ between cases and controls. In cases, we found a higher value of AUC (30.7 versus 22.5; p = 0.021).
  
  
  CONCLUSIONS
  In our retrospective cohort, we found that the levels of bilirubin and the AUC in the first eight days before the onset of sepsis in preterm infants were significantly higher than the healthy controls. These data suggest that the prolonged exposition to high levels of bilirubin could increase the infection susceptibility in preterm infants.
authors.affiliation: a Division of Neonatology , Department of Translational Medical Sciences, Università "Federico II" di Napoli , Naples , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Raimondi
authors.affiliation: a Division of Neonatology , Department of Translational Medical Sciences, Università "Federico II" di Napoli , Naples , Italy.
authors.forename: Angela Carla
authors.initials: AC
authors.lastname: Borrelli
authors.affiliation: a Division of Neonatology , Department of Translational Medical Sciences, Università "Federico II" di Napoli , Naples , Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Ferrara
authors.affiliation: a Division of Neonatology , Department of Translational Medical Sciences, Università "Federico II" di Napoli , Naples , Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Giannattasio
authors.affiliation: a Division of Neonatology , Department of Translational Medical Sciences, Università "Federico II" di Napoli , Naples , Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Capasso
mesh_terms: D019540:Area Under Curve; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D019102:Infant, Very Low Birth Weight / Q000097:blood; D000071074:Neonatal Sepsis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001663:Bilirubin
keywords: AUC; Neonate; bilirubin; prematurity; sepsis