THE VALUE OF RED CELL DISTRIBUTION WIDTH AS A PROGNOSTIC FACTOR OF EARLY ONSET NEONATAL SEPSIS: A CASE-CONTROL STUDY

*Hayat A. Mohammad, Adnan H. Dayoub, Abdulmoneim H. Ghanem

ABSTRACT

Context: Neonatal sepsis is an inflammatory systemic. Early-onset neonatal sepsis is a significant health challenge associated with high rates of both morbidity and mortality. Objectives: This study aimed to compare red cell distribution width (RDW) values in neonates with early-onset sepsis (EONS) and healthy newborns; and to determine the role of RDW as a diagnostic factor in the occurrence of early-onset neonatal sepsis. Methods and Material: A case-control study was conducted in the neonatal intensive care unit (NICU) of Lattakia Hospital, Syria. This study included all neonates admitted to the hospital between March 2024 and March 2025. Neonates at the age of one day, who completed 37 weeks of gestation were included in this study. After obtaining parental consent, all cases were subjected to history taking, thorough clinical examination and Investigations. All analyses were performed using R v 4.5.0. Results: RDW width was statistically significantly increased in the EONS group (18.9 ± 2.0%) compared to controls (13.3 ± 0.9%; p < 0.001). Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of RDW as a potential biomarker for EOS. The AUC for RDW (%) was 0.999 (95% CI: 0.997– 1.000). At the optimal threshold of 15.2, RDW showed a sensitivity of 98.1%, specificity of 100.0%. Conclusion: Our findings suggest that RDW, which can be practically assessed in complete blood count as part of the routine sepsis evaluation, may be helpful as a diagnostic marker in neonatal sepsis.

Keywords: Early Onset Neonatal Sepsis, Red Cell Distribution Width, Prognostic Marker.