Early pancreatic stone protein kinetics and subsequent inflammatory outcomes in extremely preterm neonates: A prospective cohort study.

OBJECTIVE

To evaluate pancreatic stone protein (PSP) levels in extremely preterm neonates and their association with early-onset sepsis (EOS), late-onset sepsis (LOS), and necrotizing enterocolitis (NEC).

STUDY

DESIGN

A prospective longitudinal study, evaluating serial PSP, C-reactive protein (CRP), and white blood cell (WBC) count during the first ten days after birth.

RESULTS

Thirty extremely preterm neonates with a mean gestational age of 26.5 ± 1.8 weeks and a mean birth weight of 890 ± 304 g were enrolled. PSP increased significantly 48 h before LOS presentation, with a diagnostic accuracy higher than that of CRP and WBC (AUROC 0.711, 0.567, and 0.538, respectively). PSP levels also increased from 72 h before NEC onset, with a better discriminatory ability than CRP and WBC (AUROC 0.851, 0.648, and 0.616, respectively).

CONCLUSION

PSP may represent a promising early biomarker for LOS and NEC in extremely preterm neonates. Larger multicenter studies are required to validate these findings.