Umbilical blood biomarkers for predicting early-onset neonatal sepsis

Background: Since the 1990s, finding the most efficient markers or combinations as predictors of early-onset neonatal sepsis has been the hot topic of studies. But there is no review of such biomarkers detected in umbilical blood at birth. By comparing clinical values of common inflammatory markers detected in cord blood shortly after birth, in this study we tried to find the most performing one or the most efficient combination that might be potentially used in birth room, as the earliest predictor of early-onset neonatal sepsis. Data sources: We searched PubMed and Elsevier's Web of Science for studies evaluating cord blood inflammatory markers in relation to early-onset neonatal sepsis. Results: Among C-reactive protein (CRP), procalcitonin (PCT), IL-6, IL-8, TNF-alpha and IL-1 beta none of them could be used individually to establish or exclude the diagnosis of early-onset neonatal sepsis, but PCT, IL-6 and IL-8 have great superiority to CRP, TNF-alpha and IL-1 beta. When combined with other hematological markers and clinical observation, the clinical reliability of PCT, IL-6 and IL-8 could be improved. Prolonging the sample collection time window seems to have a positive effect on the clinical utility of IL-6 and IL-8. Conclusions: More researches focusing on the combination of different umbilical cord biomarkers in different clinical settings are needed to achieve clearer conclusions. Multi-center, large-sized analysis, especially examining groups of cytokines, is also expected. World J Pediatr 2012;8(2):101-108