Correlation Between Fetal Inflammatory Response Syndrome And Neonatal Purulent Meningitis

Objective To investigate the correlation between FIRS and neonatal purulent meningitis.To investigate the effect of FIRS on the basic data,perinatal factors,clinical manifestations,laboratory examination and other related factors of neonatal purulent meningitis.To investigate the predictive value of serum hs-CRP and PCT in neonatal purulent meningitis.Methods The clinical data of 219 children with sepsis hospitalized in NICU of Inner Mongolia Maternal and Child Health Hospital from January 2015 to December 2021 were retrospectively analyzed.The sepsis patients with FIRS were set as the experimental group(group A),and the sepsis patients without FIRS were set as the control group(group B).The children in group A and group B were grouped again under the condition of purulent meningitis.They were divided into simple sepsis with FIRS(group A1)and purulent meningitis(group A2),simple sepsis without FIRS(group B1)and purulent meningitis(group B2);The correlation between FIRS and purulent meningitis was compared between group A and group B.The basic data and related factors of children with purulent meningitis were compared between group A2 and group B2.The predictive value of serum hs-CRP and PCT levels in group A and group B for neonatal purulent meningitis was discussed.Results1.There was no significant difference in gestational age,birth weight and gender between group A and group B(P > 0.05).The prevalence of purulent meningitis in group A was higher than that in group B(P < 0.05).2.There was no statistically significant difference in basic data such as gestational age,birth weight,gender,total length of stay,mode of delivery,and age of mother between group A2 and group B2(P > 0.05).The age of onset of purulent meningitis in group A2 was earlier than that in group B2,with statistically significant difference(P < 0.05).There was no significant difference in umbilical cord entanglement,intrauterine distress and neonatal asphyxia between group A2 and group B2(P > 0.05).The incidence of prenatal fever,amniotic fluid pollution and premature rupture of membranes(>12 h)in group A2 was higher than that in group B2(P < 0.05).There was no significant difference in poor response,omphalitis,jaundice,abdominal distension,apnea and shortness of breath between group A2 and group B2(P > 0.05).The incidence of fever and convulsion in group A2 was higher than that in group B2(P < 0.05).There was no significant difference in the number of white blood cells in blood routine,the number of white blood cells in cerebrospinal fluid and the content of chloride in cerebrospinal fluid between group A2 and group B2(P > 0.05).The levels of serum hs-CRP and PCT in group A2 were higher than those in group B2,and the differences were statistically significant(P < 0.05).The content of glucose in cerebrospinal fluid in group A2 was lower than that in group B2,and the differences were statistically significant(P < 0.05).3.The levels of serum hs-CRP and PCT in the two groups of children with simple sepsis and purulent meningitis were matched and compared.The levels of serum hs-CRP and PCT in the simple sepsis group(group A1 and group B1)were lower than those in the matched purulent meningitis group(group A2 and group B2),and the differences were statistically significant(P < 0.05);4.The elevated levels of serum hs-CRP and PCT in group A and group B were risk factors for neonatal purulent meningitis;5.The results of ROC curve analysis showed that the areas under the curve predicted by serum hs-CRP and PCT levels in group A were 0.766 and 0.770,respectively,and those in group B were 0.840 and 0.763,respectively.According to the principle of maximum Yordon index,the optimal cutoff values of serum hs-CRP and PCT in group A were 27.41(mg / L)and 9.58(ng / L),respectively,with the sensitivity of 77.1 % and82.9 %,and the specificity of 73.9 % and 67.4 %,respectively.The optimal diagnostic cutoff values of serum hs-CRP and PCT in group B were 23.04(mg / L)and 5.27(ng / L),respectively,with sensitivity of 77.5 % and 80.1 %,and specificity of 78.4 % and 87.5 %,respectively.Conclusions 1.FIRS can enhance the incidence of neonatal suppurative meningitis and make prematurely onset day.2.FIRS can enhance the probability of prenatal fever,amniotic fluid contamination and premature rupture of membranes in perinatal factors of children with purulent meningitis.3.FIRS can enhance the probability of fever and convulsion in children with suppurative meningitis.4.FIRS can enhance the serum h S-CRP and PCT concentration and decrease the CSF glucose concentration in children with suppurative meningitis.5.Serum h S-CRP and PCT concentration have certain value in predicting suppurative meningitis in children with or without FIRS.