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Article . 2025
License: CC BY
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Marcadores inflamatorios y clínicos predictores de mortalidad en neonatos menores de 1500 g

Inflammatory and clinical markers predicting mortality in neonates under 1500 g
Authors: Patricia González, Alma; Acuña-Cenoz, Laura Irandeni; Alcázar-Olaiz, Martha Daniela; Estevez-Alemán, Pablo Fabián; Paque-Bautista, Carlos; Sosa-Bustamante, Gloria Patricia;

Marcadores inflamatorios y clínicos predictores de mortalidad en neonatos menores de 1500 g

Abstract

Resumen Introducción: la mortalidad neonatal temprana sucede dentro de los 7 días de vida. Las variables clínicas, los marcadores inflamatorios y el CRIB (Clinical Risk Index for Babies) podrían ser útiles para identificar riesgo de mortalidad. Objetivo: analizar la utilidad de marcadores inflamatorios y clínicos para predecir mortalidad temprana en recién nacidos prematuros (RNPT) < 1500 g. Material y métodos: estudio analítico, retroprospectivo, observacional y transversal. Se incluyeron RNPT con peso al nacimiento < 1500 g. Se evaluaron características clínicas, CRIB, marcadores inflamatorios y proteína C reactiva (PCR) a las 12 horas de vida. Resultados: se estudiaron 248 RNPT, con edad gestacional de 32 semanas (RIC 30-34) y peso 1285 g (RIC 1070-1400); fallecieron 20 (8.06%). Los factores de riesgo para mortalidad fueron peso ≤ 1000 g, RM = 24 (7.69-77.96), p < 0.0001; edad gestacional ≤ 28 semanas, RM = 42 (13.71-128.61), p < 0.0001; ventilación invasiva, RM = 44.7 (5.85-340), p < 0.0001. Los factores protectores fueron los corticoesteroides antenatales, RM = 0.15 (0.05-0.39), p = 0.0001 y la preeclampsia materna, RM = 0.13 (0.01-1.02), p = 0.01. La PCR, el déficit de base y el peso al nacer se asociaron a mortalidad en el análisis multivariado (intercepto = 6.62; EE = 1.85; R2 = 0.60; p = 0.0003). La PCR ≥ 2.30 µg/dL mostró una sensibilidad de 26.32% y una especificidad de 97.50% para mortalidad, AUC = 0.69, p = 0.005. Conclusiones: los predictores de mortalidad temprana fueron el peso ≤ 1000 g, la edad gestacional ≤ 28 semanas y la PCR ≥ 2.30 μg/dL.

Background: Early neonatal mortality occurs within 7 days of life. Clinical variables, inflammatory markers and CRIB (Clinical Risk Index for Babies) could be useful to identify mortality risk. Objective: To assess the predictive value of inflammatory and clinical markers for early mortality in preterm newborns (PTNB) < 1500 g. Material and methods: Analytical, retroprospective, observational and cross-sectional study. PTNBs with birth weight < 1500 g were included. Clinical characteristics, CRIB, inflammatory markers and C-reactive protein (CRP) were evaluated at 12 hours of life. Results: 248 PTNBs were studied, with a gestational age of 32 weeks (IQR 30-34), weight 1285 g (IQR 1070-1400); 20 died (8.06%). Risk factors for mortality were weight ≤ 1000 g, OR = 24 (7.69-77.96), p < 0.0001; gestational age ≤ 28 weeks, OR = 42 (13.71-128.61), p < 0.0001; invasive ventilation, OR = 44.7 (5.85-340), p < 0.0001. Protective factors were antenatal corticosteroids, OR = 0.15 (0.05-0.39), p = 0.0001, and maternal preeclampsia, OR = 0.13 (0.01-1.02), p = 0.01. CRP, base deficit and birth weight were associated with mortality in the multivariate analysis (intercept = 6.62; SE = 1.85; R2 = 0.60; p = 0.0003). CRP ≥ 2.30 µg/dL showed a sensitivity of 26.32% and a specificity of 97.50% for mortality, AUC = 0.69, p = 0.005. Conclusions: Predictors of early mortality were weight ≤ 1000 g, gestational age ≤ 28 weeks and CRP ≥ 2.30 μg/dL.

Keywords

Aportación Original, Mortalidad Neonatal; Prematuridad; Sepsis Neonatal; Neonatal Mortality, Prematurity, Neonatal Sepsis

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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