Gökçenur KARAKELLEOĞLU, Elif Ceren Nur KIRIMLI YANIK, Şenol BOZDAĞ
Anatolian Journal of Obstetrics and Gynecology Research - 2025;2(3):129-134
Purpose: To identify maternal, perinatal, and neonatal factors distinguishing early-onset sepsis (EOS) from late-onset sepsis (LOS). Methods: This retrospective study included 74 neonates with sepsis (April 2022 and April 2025) with complete maternal laboratory data. EOS was defined as <=72 h (n=34) and LOS as >72 h (n=40). Maternal/perinatal variables, neonatal laboratory parameters (including hemoglobin), and inflammatory indices [neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, systemic immune-inflammation index (SII), systemic inflammation response index, pan-immune-inflammation value] were compared. Predictors were assessed using logistic regression and receiver operating characteristic (ROC) analysis. Results: Cesarean delivery, in vitro fertilization, and maternal antibiotic use were more frequent in LOS (p<0.05). EOS infants had lower gestational age (195.5 vs. 267 days, p<0.001) and birth weight (1210 vs. 3200 g, p<0.001). Maternal hemoglobin did not differ (p=0.140), whereas neonatal hemoglobin was significantly lower in EOS (17.5 vs. 18.7 g/dL, p<0.001). CRP, white blood cell count, and neutrophils were higher in LOS. Among indices, only NLR and SII were elevated in LOS (p=0.025, p=0.009). In multivariate analysis, neonatal hemoglobin [odds ratio (OR)=0.707, 95% confidence interval (CI): 0.553-0.904, p=0.006] and vaginal delivery (OR=0.068, 95% CI: 0.007-0.632, p=0.018) independently predicted EOS. ROC of neonatal hemoglobin showed moderate discrimination (AUC=0.741) with a cut-off of 17.5 g/dL (sensitivity 82.4%, specificity 50.0%). Conclusion: Neonatal hemoglobin and delivery mode independently predicted EOS, whereas NLR and SII were higher in LOS. Simple clinical and hematologic parameters may help differentiate sepsis timing.
