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 (<0.001). There was a significant increase in CRP value during the rewarming phase of TH in both CRP-P and CRP-N groups (<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.