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Abstract

Objective: Early-onset neonatal sepsis (EOS) is a common cause of mortality in the neonatal period. The purpose of the study was to determine the value of the neutrophil-to-lymphocyte ratio (NLR) in the early diagnosis of EOS. Methods: This was a prospective cross-sectional study. A total of 102 newborns with early-onset infection (EOI) were enrolled within the first 72 hours of life in the neonatal intensive care unit of a tertiary referral hospital, the largest pediatric center in central Vietnam. Results: Among 102 newborns, 32 were identified as having EOS, while the remaining 70 were classified as EOI. The median NLR value in the EOS group (2.7 [2.0–5.6]) was statistically significantly higher than that in the EOI group (1.7 [1.0–2.4], p < 0.05). The NLR demonstrated a moderate ability to discriminate between EOS and EOI with the area under the curve (AUC) of 73.6% (p < 0.05). An NLR cut-off of 1.87 was found to be optimal, with a sensitivity of 84.4%, a specificity of 60.0%, a positive predictive value of 49.1%, and a negative predictive value of 89.4%. The combination of NLR and C-reactive protein demonstrated the best performance in predicting EOS, with the AUC of 85.3% (95% confidence interval: 76.9–91.5). Conclusions: This study suggests that NLR can be used as an additional diagnostic marker, alongside C-reactive protein, for the early diagnosis of EOS.

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