C-Reactive Protein and Blood Gas Analysis in Cases of Neonatal Encephalopathy Treated with Therapeutic Hypothermia.

OBJECTIVE

Neonatal encephalopathy (NE) is one of the important causes of mortality and morbidity today. Therapeutic hypothermia (TH) applied to moderate and severe NE patients has neuroprotective effects. The role of C-reactive protein (CRP) in determining the clinical severity of NE is not clear.

METHODS

Medical records of 118 NE patients treated with TH were reviewed. The patients were divided into two groups as CRP positive (CRP-P) (≥1 mg/dL) and CRP negative (CRP-N) (<1 mg/dL) according to the CRP value measured immediately before rewarming phase during TH. Cord blood base deficits (BD) and pH were also examined.

RESULTS

According to Sarnat&Sarnat classification, moderate NE cases were more frequent in the CRP-N group, whereas severe cases were more frequent in CRP-P group (p<0.001). There was a significant increase in CRP value during the rewarming phase of TH in both CRP-P and CRP-N groups (p<0.001). The specificity and sensitivity for CRP (measured during TH) predicting NE severity was 72% and 77%, respectively (AUC:0.742). For cord blood BD (AUC: 0.845) 79% sensitivity and 78% specificity were found, whereas pH (AUC: 155) had 10% sensitivity and 60% specificity.

CONCLUSION

CRP level measured immediately before the rewarming phase may be useful biomarker for NE severity along with cord blood BD.