Prognostic Value of Anti-Thrombin III Level in Neonatal Sepsis

Abstract

Background: To determine levels of Antithrombin
III and its prognostic value in predicting
neonatal sepsis.
Methods: In this descriptive study full term
neonates (n=70)were recruited. For the diagnosis of
neonatal sepsis 2 or more of the physical signs and
laboratory criteria were taken into account
for(temperature instability< 35 or > 38.5C;tachypnea
> 60/min; tachycardia > 200/min;capillary refill > 3
sec; C-reactive protein level > 1 ng/ml). Neonates in
which factors which affect the prognosis irrespective
of disease severity of neonatal sepsis and neonates
who presented with complications of sepsis such as,
multiple congenital anomalies, birth weight < 2 kg,
birth asphyxia, neonates who received prior
treatment or presenting with complications were
excluded. Patients with Anti-thrombin III levels less
than 35 UIU/dl were considered as bad prognostic
group and those with Anti-thrombin III level
between 50 – 75 IU/ dl were considered as good
prognostic group .The neonates were followed for 2
weeks. Outcomes were assessed in terms of total
duration of hospital stay, complications developed,
discharge or death of the neonate. p- value less than
or equal to 0.05 was considered significant.
Results: The mean Anti-thrombin III level in the
good prognosis group was 53.098.8 whereas in the
bad prognosis group was 41.6610.58 IU/dl(p <0.05).
Anti-thrombin III level below 50 IU/dl had a
sensitivity of 62.8%, specificity of 77.1%, positive
predictive value of 73.3% and a negative predictive
value of 67.5% for predicting poor prognosis and
death.
Conclusion: Anti-thrombin III levels can be a
potential indicator of prognosis in neonatal sepsis.