Early postnatal C-reactive protein elevation during initial hospitalization in neonates with giant omphalocele undergoing delayed repair

TL;DR

This study examines how C-reactive protein levels change in newborns with giant omphalocele during early hospitalization, finding elevated levels that don't always indicate infection.

Contribution

The study provides preliminary insights into CRP dynamics in neonates with giant omphalocele undergoing delayed repair and its clinical correlations.

Findings

CRP levels peaked on the 5th day after birth and remained high for several days.

Higher peak CRP levels correlated with longer hospital stays.

CRP elevation was not strongly linked to proven infections, suggesting caution in antibiotic use.

Abstract

To preliminarily describe the dynamic changes and clinical characteristics of serum C-reactive protein (CRP) in giant omphalocele (GO) neonates with delayed repair during the early postnatal period.

A retrospective study included 15 neonates with GO who underwent delayed repair at our hospital. CRP was collected at 0, 5, 7, 10, 14, 21 days after birth and before discharge. Data on hospital stay duration, complications, and anti-infection treatment were recorded. Descriptive statistics were used to present the trend of CRP changes, and the relationship with clinical indicators was preliminarily analyzed.

Among the 15 full-term neonates (average gestational age 38.5 weeks, birth weight 2,821 g), CRP reached a peak value on the 5th day after birth (median 87.1 mg/L), followed by a decreasing trend but remaining at a high level (78.0, 67.2, and 48.0 mg/L on the 7th, 10th, and 14th days, respectively). The peak CRP level was positively correlated with the hospital stay duration (R = 0.78, p = 0.001). 73.3% (11/15) of the GO neonates received empirical antibiotic treatment (average course of 11 days), while the pathogen positivity rate was only 20% (3/15), and all were cultured from the sac membrane secretions. Based on the duration of continuous CRP elevation as the classification criterion, it was found that neonates with a longer duration of elevated CRP had larger defects, longer hospital stays, and longer time to achieve full enteral nutrition.

Neonates with GO undergoing delayed repair exhibit significant CRP elevation in the early postnatal period, but this rise correlates poorly with proven infection. Clinicians need to carefully interpret the changes in CRP and avoid excessive anti-infection treatment. This retrospective study provides preliminary data and hypothesis basis for subsequent large-sample studies.

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