Evaluation Of Some Blood Biomarkers As Predictors Of Neonatal Necrotizing Enterocolitis

Abstract Background Necrotizing enterocolitis is a leading cause of mortality and morbidity in preterm neonates; however the lack of a reliable biomarker makes definite diagnosis difficult. Therefore, its early suspicion and proper management are important. Objective To evaluate the value of NLR, serum levels GGT, total serum bilirubin and serum Ca2+ concentrations for early diagnosis and prediction of NEC severity; and to make a predictive score for early diagnosis of NEC. Patients and methods A case control study which was conducted on neonates admitted to NICU, Children Hospital, Ain Shams University over a period of 6 months, fifty neonates were classified into two groups: the patients group included 25 neonates with NEC with a gestational age 28-36 weeks regardless of birth weight matched with control group which included 25 healthy preterm neonates, however we excluded neonates with congenital infectious diseases, perinatal asphyxia, severe birth defects, congenital digestive tract malformations, inherited metabolic diseases or parental refusal of enrollment. Results ROC curve of NEC diagnosis by NLR, serum GGT, total serum bilirubin and serum Ca2+ showed cut off: > 1.13, > 40 U/L, > 0.95 mg/dl, < 8.85 mg/dl respectively, Sensitivity 84, 92%, 84%, 84% respectively and Specificity 80%, 92%, 92%, 84% respectively; also beta-weighted score for prediction of NEC disease showed that NLR (Best cut off > 1.13) or GGT (Best cut off > 40 U/L could be helpful with sensitivity 92% and specificity 92%. Conclusion NLR, GGT, T.Bil and calcium levels could be good non-invasive markers for NEC disease prediction and also for its diagnosis.