Umbilical cord blood serum procalcitonin concentration in the diagnosis of early neonatal infection.

OBJECTIVE: To evaluate serum procalcitonin concentration in umbilical cord blood for diagnosis of intrauterine bacterial infection. MATERIALS AND METHODS: A prospective study was conducted between 2000 and 2001. Serum procalcitonin concentrations were evaluated in 187 umbilical cord blood samples. Five groups have been defined: controls A (n=37), full-term noninfected B1 (n=80) and infected neonates B2 (n=8), preterm noninfected C1 (n=38) and infected C2 (n=24) newborns. An immunoluminometric assay was used to determine procalcitonin concentration. The Mann-Whitney U-test and Spearman's correlation ratio were applied. The sensitivity and specificity, the positive and negative predictive values, and the area under receiver operating characteristic curves were calculated. RESULTS: A statistically higher serum procalcitonin concentration was found in the preterm infected group (p<0.005; C2 vs A and C1). CONCLUSION: Serum procalcitonin concentration in umbilical cord blood may be a useful parameter in the diagnosis of early neonatal infection.     

Procalcitonin as a marker of perinatal infection in newborn--preliminary data

Intrauterine and intrapartum infections in newborn infants are still difficult to recognise. The newborn does not manifest the classic clinical signs of infection usually observed in children and adults and up to now there is no good laboratory marker. In the last few years, procalcitonin (PCT) has been found to increase during different inflammatory processes, especially bacterial ones. In this study we analysed the clinical value of PTC in parturient, umbilical cord and newborn blood for predicting perinatal infection. MATERIAL AND METHODS: Thirty parturients with symptoms of intrauterine infection were classified for this study. Blood samples were obtained from the mother, the umbilical cord and the newborn on the second day of life. Serum was stored at -70 degrees C and thawed at the time of analysis. Among the newborns there were 21 infants without and 9 with symptoms and signs of infection. PCT concentration was measured by immunoluminometric assay--LUMI test PCT (BRAHMS). RESULTS: Statistically significant results were found on the second day of life: 5.83 (4.70) ng/ml in ill, 1.41 (0.68) ng/ml in healthy (p < 0.0005). We observed a significant correlation between PCT concentration in mother and umbilical cord blood (y = 0.40x + 1.06; p < 0.05), as well as between umbilical cord blood and venous blood on the second day of life in newborns (y = 0.16x 1.21; p < 0.01). CONCLUSIONS: Measurement of PCT concentration in perinatal period in the mother and in umbilical cord blood of the newborn may be useful for early diagnosis and monitoring of infectious complications in neonates. We need more data on reference ranges of PCT concentration in pregnant women, parturients and umbilical cord blood.     

Increased cortisol concentrations in the cord blood of newborns whose mothers smoked during pregnancy

AIM: To investigate the effect of tobacco smoke on cord blood cortisol concentrations. METHODS: Cortisol concentrations were measured in cord blood from 211 term newborns of smoking and 211 term newborns of nonsmoking mothers; 48 and 36 newborns were delivered by cesarean section, respectively. In 16 cases, in addition to cord blood, maternal venous blood was obtained at delivery. RESULTS: The median cord blood cortisol concentration in neonates of the smoking and the nonsmoking mothers was 23 and 13 microg/dL, respectively (P<0.0001). Cortisol concentrations were greater in the newborns whose mothers smoked, when compared to corresponding controls, whether they were delivered vaginally or by cesarean section. In the newborns delivered by cesarean section, there was a positive correlation between number of cigarettes smoked/day and cortisol concentrations, as well as a negative correlation between cortisol concentrations and neonatal length. There was no significant correlation between cortisol concentrations and birth weight or head circumference. Cortisol concentrations in the cord blood of neonates whose mothers were smokers and nonsmokers were by 29% and 45% lower from those measured in their mothers, respectively. CONCLUSIONS: Although a causal relationship between maternal smoking and high cortisol concentrations in cord blood was not established, the findings are in accordance with previous reports indicating elevated stress-hormones in newborns whose mothers smoked during pregnancy.     

Oxidative stress as determined by glutathione (GSH) concentrations in venous cord blood in elective cesarean delivery versus uncomplicated vaginal delivery

OBJECTIVE: To determine whether neonates are subject to oxidative stress by the labor process and the mode of delivery by measuring glutathione (GSH) concentrations in umbilical cord venous blood. STUDY DESIGN: Forty-eight women with singleton term pregnancies were prospectively recruited and classified as follows: 26 women had a spontaneous uncomplicated vaginal delivery (VD), and 22 women had an elective cesarean delivery (CD). GSH concentration in umbilical venous blood samples was determined by a spectroscopic method. RESULTS: Umbilical cord venous blood GSH levels were significantly lower in the elective CD group than in the VD group (2.2 and 2.7 mM, respectively, P = 0.0003). There was a significantly negative correlation between cord blood pO(2) and GSH levels; however, the negative correlation was significantly higher in the elective CD group (P < 0.05). CONCLUSION: Neonates delivered by CD were exposed to a higher oxidative stress as determined by GSH levels compared to those who had an uncomplicated VD.     

Correlations between umbilical and maternal serum adiponectin levels and neonatal birthweights

OBJECTIVE: To measure adiponectin levels in maternal serum and umbilical cord serum at delivery, and examine whether or not there are correlations between adiponectin levels and neonatal birthweights, maternal body weights and body mass indexes. STUDY DESIGN: The study included 84 healthy mothers who had given birth to healthy neonates. Adiponectin levels in maternal serum and umbilical cord serum were determined by radioimmunoassay and compared. RESULTS: The ranges of adiponectin levels for umbilical cord serum and maternal serum were 22.7-78.4 microg/ml and 4.0-43.3 microg/ml, respectively. Umbilical serum adiponectin levels (46.9 +/- 1.2 microg/ml) were significantly higher than maternal serum adiponectin levels (16.1 +/- 0.8 micro g/ml) (p < 0.001). No correlation was found between the adiponectin levels in maternal serum and those in umbilical cord serum (r = 0.158, p = 0.151). Umbilical serum adiponectin levels were significantly correlated with both neonatal birthweights (r = 0.454, p < 0.001) and gestational ages at birth (r = 0.295, p = 0.006), but not with maternal serum adiponectin levels. Maternal serum adiponectin levels were only negatively correlated to maternal weights and body mass index at delivery (r = 0.288, p = 0.008; r = 0.372, p < 0.001). CONCLUSION: The levels of adiponectin were higher in umbilical cord serum than in maternal serum. Moreover, the adiponectin levels in umbilical cord serum were found to correlate positively with neonatal birthweights. Therefore, fetal adiponectin, not maternal serum adiponectin, may be involved in fetal development during late pregnancy.     

Maternal serum and umbilical cord blood leptin concentrations with fetal growth restriction

OBJECTIVE: To ascertain whether fetal growth restriction is associated with alterations of leptin concentrations in umbilical cord blood and maternal serum. METHODS: Maternal serum and umbilical cord blood leptin concentrations were determined by immunoradiometric assay at term in 43 women with uncomplicated singleton pregnancies (group A) and in 27 women with singleton pregnancies complicated by fetal growth restriction (group B), all with normal pregravid body mass index (BMI). RESULTS: Maternal serum leptin concentrations were significantly higher in group B compared with group A (45.0 ng/mL [range 34.2-54.9] versus 29.0 ng/mL [range 24.7-33.3]; P<.01). Umbilical cord blood leptin levels were significantly lower in group B compared with group A (8.4 ng/mL [range 3.6-13.2] versus 13.1 ng/mL [9.7-16.5]; P<.01). Maternal serum leptin levels were not significantly correlated with maternal BMI or with neonatal birth weight in either group. Umbilical cord blood leptin concentrations were significantly correlated with neonatal birth weight in both groups. CONCLUSION: Growth restricted fetuses at term show umbilical cord blood leptin concentrations significantly lower than those in normal fetuses, suggesting that fetal adipose tissue is a major source of leptin. Maternal serum leptin concentrations are higher in the presence of a growth restricted fetus. This increase might be due to an intrinsic placental mechanism, by which small placentas produce more leptin as a compensatory mechanism, or to early hypoxia.     

Profile of trace element concentrations in the feto-placental unit in relation to fetal growth

BACKGROUND: During pregnancy, trace elements are indispensable for life maintenance not only for the mother but also for the fetus. The purpose of this study was to examine whether fetal growth is associated with altered levels of trace elements in maternal blood, fetal blood, and placenta tissue. METHODS: Twenty-one pairs of healthy mothers and their newborns with intrauterine growth restriction delivered after 34 weeks of gestation were recruited for the study. In addition, 30 pairs of healthy mothers and their appropriate for gestational age newborns were included as controls. Maternal venous blood, umbilical cord venous and arterial blood, and placenta tissue were collected immediately after delivery. Six essential elements, magnesium, manganese, iron, copper, zinc, and selenium, and four other elements, rubidium, strontium, cadmium, and cesium, in those samples were determined by inductively coupled plasma mass spectrometry or inductively coupled plasma atomic emission spectrometry. RESULTS: Compared with appropriate for gestational age cases, intrauterine growth restriction cases showed higher magnesium, copper, and selenium concentrations in umbilical cord arterial sera, and higher magnesium and selenium concentrations in placenta tissue, but no significant differences appeared for the elements measured in maternal and umbilical cord venous sera. The umbilical cord venous vs. maternal sera concentration ratio was elevated for copper, and the umbilical cord arterial vs. umbilical cord venous sera concentration ratios were elevated for copper and zinc, but there were no differences in placenta tissue vs. maternal sera concentration ratios in intrauterine growth restriction cases. CONCLUSIONS: Among the trace elements evaluated, magnesium, copper, zinc, and selenium showed elevated concentrations in umbilical cord arterial blood, or elevated umbilical cord arterial vs. umbilical cord venous blood concentration ratios in intrauterine growth restriction cases. Reduced consumption efficiency of these four essential trace elements may be closely associated with retarded fetal development.     

Il-1 beta, Il-6, Il-8 and G-CSF in the diagnosis of early-onset neonatal infections

OBJECTIVE: To determine whether inflammatory cytokine concentrations (Il-1 beta, Il-6, Il-8 and G-CSF) in umbilical cord blood are useful predictors of an early-onset neonatal infection. MATERIAL AND METHODS: 240 women and their newborns were enrolled in our study and umbilical cord blood samples collected from neonates (n = 240) were subjected to ELISA for Il-1 beta, Il-6, Il-8 and G-CSF. Clinical outcome of the neonates was followed and documented. Placenta histology was also available in majority of the cases (n = 195). RESULTS: Early-onset neonatal infection was diagnosed in 5.4% of neonates (13/240) and placental examination showed histologic chorioamnionitis in 17.9% (35/195). Both Il-1 beta and Il-6 cord blood concentrations were elevated in association with histologic chorioamnionitis (Il-1 beta-2.7 vs. 2.1 pg/ml, p < 0.05 and Il-6 15.6 vs. 12.8 pg/ml, p < 0.005). Only Il-6 was elevated (16.0 vs. 13.2 pg/ml, p < 0.05) in neonates with early-onset bacterial infections. ROC analysis showed acceptable diagnostic performance of Il-6 in the identification of acute histologic chorioamnionitis and clinical neonatal infection. CONCLUSION: Il-6 in umbilical cord blood seems to be a promising predictor for early-onset neonatal infections.     

Umbilical venous leptin concentration and gender in newborns

OBJECTIVE: To investigate the relationship between umbilical venous leptin concentration and gender in 20 pairs of newborns matched 1:1 for birth weight and gestational age at sampling. MATERIALS: Blood samples were obtained from 40 women at delivery, identified as having an uncomplicated pregnancy. Umbilical venous blood samples were obtained from their newborns (20 males and 20 females) at birth. Specimens were analyzed using a human leptin 125-I radioimmunoassay. RESULTS: Fetal leptin correlated positively with birth weight (rs = 0.541; P < .001). Umbilical venous leptin concentrations in female newborns (median: 10.7 ng/mL, range: 3.5-34.4 ng/mL) were significantly higher (P = .028) than in male newborns (median: 7.7 ng/mL, range: 2.0-19.3 ng/mL). There was no significant correlation between maternal and fetal leptin concentrations. Multiple logistic regression analysis revealed birth weight and gender to be independent factors influencing fetal cord leptin. CONCLUSION: Our results suggest that in the fetus, as in children and adults, gender and weight are the major determinants of circulating leptin levels.     

Correlations between umbilical and maternal serum resistin levels and neonatal birth weight

OBJECTIVE: Resistin is a novel hormone secreted by human adipocytes and mononuclear cells. It is expressed in the human placenta, and has been postulated to play a role in the regulation of energy metabolism during pregnancy. However, correlations between umbilical and maternal serum resistin levels and neonatal birth weight remain poorly understood. The purpose of the study was to clarify the correlation between umbilical cord and maternal serum resistin levels and neonatal birth weight. MATERIALS AND METHODS: This study included 37 healthy mothers, neonates. Resistin levels were determined by ELISA, and compared for correlation between umbilical cord and maternal serum resistin levels and neonatal birth weight. RESULTS: The ranges of resistin levels for umbilical and maternal sera were 10.61-40.81 and 1.14-25.54 ng/ml, respectively. Mean umbilical serum resistin level (21.34+/-1.07 ng/ml) was significantly higher than maternal serum resistin level (10.13+/-1.12) (p<0.001). Umbilical serum resistin levels were positively correlated with maternal serum resistin levels (r=0.607, p<0.001) and negatively with neonatal birth weight (r= - 0.345, p=0.037). No significant differences in resistin levels were discovered between the female and male neonates. In addition, there were no correlation between the umbilical resistin levels and maternal body mass indices, umbilical leptin levels, or insulin levels. CONCLUSIONS: It is suggested that resistin not only affects energy homeostasis by existing in high levels in the fetus, but may play an important role in controlling body weight through effective regulation of adipogenesis by negative feedback.     

The fetomaternal dependency of cord blood interleukin-6.

Interleukin-6 (IL-6) plays a major role in hematopoiesis, immune functioning, and the acute phase response. In umbilical cord blood, this cytokine was thought to be a marker of neonatal defense to stress and infection, however, neonatal IL-6 production is immature. We speculated that a maternal influence exists on neonatal IL-6, at least during uncomplicated deliveries. Of the 81 healthy parturients included in this study, 51 delivered vaginally, 20 with and 31 without epidural analgesia, and 30 underwent elective cesarean section, 20 with epidural and 10 with general anesthesia. Maternal blood was sampled on hospital admission and just after delivery. Neonatal blood was collected from the umbilical cord. A significant positive correlation was found between neonatal cord blood interleukin-6 levels and maternal serum IL-6 levels on admission (r = 0.57, p <0.001) and just after delivery (r = 0.79, p <0.001). This was not influenced by the type of delivery or anesthesia. Neonatal IL-6 levels were weakly negatively correlated with the duration of gestation and with the Apgar score 1 min after birth. A feto-maternal dependency of neonatal IL-6 on maternal serum IL-6 levels implies a priming or modulatory role of the maternal immune system on that of the neonate.     

Placental and serum levels of carotenoids in preeclampsia

OBJECTIVE: We compared placental tissue, maternal serum, and umbilical cord venous blood levels of four dietary carotenoids (alpha-carotene, beta-carotene, lycopene, and canthaxanthin) in normal pregnant women and those with preeclampsia. METHODS: Levels of alpha-carotene, beta-carotene, lycopene, and canthaxanthin were measured in placental tissue, maternal serum, and umbilical cord venous blood from 22 normal pregnant women and 19 women with preeclampsia. The criteria for recruitment included gestational age of 30-42 weeks, singleton pregnancy, intact membranes, absence of labor contractions, and absence of any other medical complication concurrent with preeclampsia. Carotenoids were measured using high-pressure liquid chromatography. RESULTS: All four carotenoids were detectable in human placental tissue, maternal serum, and umbilical cord venous blood samples. The levels of beta-carotene, lycopene, and canthaxanthin in placentas from preeclamptic women were significantly lower (P =.032, .009, and .013, respectively, by Mann-Whitney test) than those from normal pregnant women. Maternal serum levels of beta-carotene and lycopene were significantly lower (P =.004 and .008, respectively, by Mann-Whitney test) in women with preeclampsia. However, umbilical cord venous blood levels of these carotenoids were not significantly different between the two groups. CONCLUSION: Lower placental tissue and maternal serum carotenoid levels in women with preeclampsia suggest that oxidative stress or a dietary antioxidant influence might have an effect on the pathophysiology of preeclampsia.     

Activated protein C resistance in cord blood from healthy and complicated newborns.

OBJECTIVES: Newborns are susceptible to thrombosis secondary to the immature hemostatic system and maternal and fetal complications. The contribution of activated protein C resistance (APCR) to thrombosis tendency has not yet been established. This study was conducted to investigate the effects of maternal and fetal complications on APCR levels. METHODS: APCR levels were determined in cord blood from healthy term infants and compared with those in healthy preterm and complicated neonates as well as that in adult venous blood. RESULTS: The mean value of APCR in cord blood from healthy term infants (166 +/- 40 s) was not significantly different from that in adult venous blood (173 +/- 40 s). No significant differences in the mean cord blood APCR values were observed between healthy term and preterm infants, infants with vaginal and cesarean delivery, infants from preeclamptic and non-eclamptic mothers, and infants with or without perinatal asphyxia. The activity levels of protein C, protein S, and antithrombin III were not significantly different between these groups except for lower levels in preterm babies. CONCLUSIONS: The level of APCR in cord blood is comparable to that in adults and not influenced by maternal and fetal complications. It appears that APCR does not contribute to the thrombotic tendency in newborns.     

Late-preterm cesarean delivery and chemokines concentration in the umbilical cord blood of neonates

Objective: The objective of the study was to investigate whether concentrations of chemokines in the umbilical cord blood of neonates are affected by delivery via cesarean section. Study design: Umbilical cord blood was obtained from 116 singleton late-preterm and full-term neonates without infections, born to healthy pregnant women. Concentrations of chemokines – MIP-1α (CCL3), MIP-1β 1 (CCL4), RANTES (CCL5), GRO-α (CXCL1) and ENA-78 (CXCL5) – were measured by ELISA. Logistic regression was used to investigate regression relationships between the occurrence of neonatal chemokines concentrations in umbilical cord blood and mode and time of delivery. Results: Concentrations of CXC chemokines in late-preterm neonates were the same as those in term neonates. RANTES concentrations in late-preterm cord blood were significantly lower than concentrations in term cord blood. Concentrations of the CC chemokine – RANTES (CCL5) – were noted to be lower in neonates born to cesarean section than in neonates born vaginally. Any anesthetic taken by the mothers during cesarean section did not affect CC chemokine production in the cord blood of full-term neonates. In a logistic regression model including gestational age as a variable, late-preterm delivery was associated with RANTES concentrations (OR = 3.8). After adjustment for variable mode of delivery in regression model, RANTES concentration (OR = 4.75). Conclusion: Both late-preterm and cesarean delivery are essential risk factors of low RANTES (CCL5) concentrations in the umbilical cord blood.     

Maternal serum leptin concentrations do not correlate with cord blood leptin concentrations in normal pregnancy

OBJECTIVE: To determine whether there is a difference in maternal leptin concentration and cord blood concentration, consistent with the hypothesis of a noncommunicating, two-compartement model of fetoplacental leptin regulation. METHODS: Blood samples were collected from 139 women, identified as having an uncomplicated pregnancy, from an antecubital vein at delivery. Cord blood samples were taken from the umbilical vein. Leptin was measured by radioimmunoassay, and its relationship to fetal and maternal anthropometrics was assessed by Spearman correlation. Differences in maternal and cord blood leptin levels between male and female infants were tested with the Mann-Whitney Utest. Maternal and cord blood leptin were compared by the Wilcoxon signed rank test. The outcome measures were maternal and cord blood leptin at delivery, fetal birth weight, length, weight/length ratio, and ponderal index, maternal prepregnancy body mass index, pregnancy weight gain, relative weight gain, and body mass index at delivery. RESULTS: No correlations were found between maternal and cord blood leptin concentrations. Fetal leptin level correlated with birth weight (rho = 0.665; P <.0001), length (rho = 0.490; P <.0001), ponderal index (rho = 0.260; P =.002), and weight/length ratio (rho = 0.625; P <.0001). Median leptin concentrations were higher in female (9.3 ng/mL, range 1.5-34.4 ng/mL) than in male (8.2 ng/mL, range 1.6-38.3 ng/mL) neonates, but this difference was statistically not significant. Logistic regression analysis showed a significant influence on umbilical venous leptin concentration for birth weight (P <.0001) but not for gender. Maternal leptin concentrations were significantly higher than cord leptin concentrations (P <.0005 for the male and female neonates and the entire group). CONCLUSION: There was no correlation between maternal and cord leptin, which supports the hypothesis of a noncommunicating, two-compartment model of fetoplacental leptin regulation.     

Chitotriosidase and YKL-40 in normal and pre-eclamptic pregnancies

OBJECTIVE: To compare macrophage activation in normal and pre-eclamptic pregnancies by determining YKL-40 concentration and chitotriosidase activity in maternal and cord serum. METHODS: In this prospective case-control study samples of maternal peripheral blood and umbilical venous blood were collected from 28 pre-eclamptic and 24 normotensive pregnant women and their newborns. YKL-40 concentration and chitotriosidase activity were determined by enzyme-linked immunoassay and fluorometry, respectively. RESULTS: Chitotriosidase activity in maternal and cord serum and YKL-40 concentration in cord serum were significantly higher in pre-eclamptic pregnancies (P<0.001), but there was no significant difference in maternal serum levels of YKL-40 between the case and control groups (P>0.05). There was a significant positive correlation between diastolic blood pressure and (1) chitotriosidase activity in both maternal and cord serum and (2) cord serum concentration of YKL-40 (r=0.61, r=0.84, and r=0.58, respectively). CONCLUSION: This study may be the first to demonstrate maternal and fetal macrophage activation in pre-eclampsia.     

Interleukin-6 in preterm premature rupture of membranes as an indicator of neonatal outcome

BACKGROUND: The aim of this study was to investigate whether the levels of interleukin-6 (IL-6) can be used as markers of adverse outcome in preterm neonates born after preterm premature rupture of membranes (PPROM). METHODS: This study involved 109 preterm neonates and their mothers. The PPROM group consisted of 58 neonates who were born after PPROM, and the control group consisted of 51 neonates. IL-6 levels were measured in umbilical cord blood, maternal blood sampled during delivery and in neonatal blood taken on the fourth day of life. RESULTS: In the PPROM group, IL-6 concentrations in maternal blood, cord blood, and neonatal blood were significantly higher in neonates with sepsis, compared with those without sepsis (P < 0.001). Choosing 108.5 pg/ml as a cut-off concentration of IL-6 in umbilical cord blood for neonatal sepsis resulted in sensitivity 95%, specificity 100%, positive predictive value 100%, and negative predictive value 97.4%. Concerning IL-6 in maternal blood, a cut-off concentration of 81 pg/ml showed sensitivity 90%, specificity 97.4%, positive predictive value 94.7%, and negative predictive value 94.9%. Eighteen of 20 neonates with early sepsis and seven of nine neonates, who died in the PPROM group, were born of mothers with IL-6 levels above the cut-off concentration in their blood during delivery. CONCLUSIONS: IL-6 in umbilical cord blood was the most significant variable for predicting early onset sepsis in preterm neonates. IL-6 in maternal blood was indicative of intrauterine environmental threats and might be used to identify pregnancies where intervention would be appropriate.     

Leptin concentrations in the umbilical vein and artery. Relationship to maternal and neonatal anthropometry

OBJECTIVE: To determine the relationships between serum leptin levels in the umbilical vein (UV) and artery (UA) and the anthropometry of mothers and neonates. STUDY DESIGN: Blood was taken from 61 pregnant women who were admitted for delivery and from the umbilical vein and artery just before delivery of the placenta. Leptin level was measured by immunoradiometric assay. Comparisons between serum leptin concentrations in UVs and both maternal and neonatal anthropometry were made according to neonatal sex. RESULTS: Mean leptin UA and UV concentrations in female infants were significantly higher than those in male infants (both, P = .002). Leptin concentrations in UVs of the total infants were related to maternal body weight and body mass index preconceptionally as well as at birth, to neonatal birth weight, to gestational age, to Kaup index and to body fat content of the infants. CONCLUSION: A sex difference was observed not only in serum leptin concentrations UA and UV but also in the degree of significance between the relationship of cord leptin and both maternal and neonatal anthropometry. Also, the UA leptin level had a closer relationship to neonatal anthropometry, but the UV leptin level was more closely related to maternal anthropometry.     

Comparison of hematologic indices and markers of infection in umbilical cord and neonatal blood

Abstract

Objective: Evaluation of a neonate for suspected early neonatal sepsis routinely includes blood tests such as complete blood count, C-reactive protein (CRP) and culture. In order to obviate the need for venepuncture, we prospectively compared these tests in paired samples from umbilical cord and peripheral venous blood drawn during the first hours after birth in both preterm and term infants.

Methods: Paired blood samples were studied from asymptomatic neonates with risk factors for early sepsis. Data were collected on maternal and neonatal factors that may have influenced the correlation between the tests.

Results: Three hundred fifty pairs of samples were studied. Significant correlation between umbilical cord and peripheral venous samples was found for white blood cell (WBC; r?=?0.683) and platelets (PLT) (r?=?0.54). Correlation for hemoglobin was lower (r?=?0.36). No cases of early neonatal sepsis were detected. However, contamination rates were 12% in umbilical cord blood and 2.5% in peripheral venous blood cultures. WBC rose after birth and the 90th percentile rose from 22?500 in umbilical cord blood to 29?700 in peripheral blood.

Conclusions: Screening for sepsis with umbilical cord CBC may be useful provided normal ranges are adjusted accordingly.