Objectives The objective of this study was to evaluate a new nontraditional value of the red cell distribution width (RDW) in predicting the clinical outcome of neonatal sepsis. Methods In this retrospective study, data were collected from the medical files of 500 full-term neonates with a diagnosis of early onset or late onset sepsis. Baseline RDW and other traditional biomarkers, including C-reactive protein (CRP), total leucocytic count, and platelet count were analyzed in light of the clinical data. The primary outcome was 30-day mortality. Results Red cell distribution width was significantly higher in nonsurvivors compared with survivors (P < 0.0001). Red cell distribution width was significantly elevated in infants with septic shock compared with those having severe sepsis and those with sepsis (P < 0.0001). A strong positive correlation was found between RDW and CRP (r = 0.8; P <0.0001). Red cell distribution width had an area under the receiver operating characteristic curve of 0.75 for prediction of mortality, which was almost equal to that of CRP and platelet count. Furthermore, logistic regression analysis showed a positive association of RDW with mortality (odds ratio, 1.31; 95% confidence interval, 1.241–1.399). Conclusions Red cell distribution width is a useful prognostic marker in neonatal sepsis. Larger prospective studies are required to confirm the value of this routinely available marker in this category of patients.

Aim: To estimate the blood level of Erythropoietin(EPO) in neonates with anemia of prematurity (APO) and in late hypo-regenerative anemia and to clarify role of EPO in correction of anemia and reducing the number of blood transfusions. Methods: This study was carried out on 60 neonates divided into; group I (30 preterm neonates) with AOP received EPO (250 IU/kg/dose subcutaneously 3 times weekly for 4 weeks), compared to group II (30 neonates) with AOP treated only with blood transfusion. CBC parameters and transfusion requirements were followed during therapy. Serum level of EPO was measured by ELISA technique. Results: By the end of the 4th week of therapy, there was significant increase in group I post r-Hu EPO compared to group II regarding reticulocyte counts (P < 0.001) leading to rise of the Hb (P < 0.001), Hct levels (P < 0.001) with subsequent reduction in the overall number of blood transfusions (P < 0.001). Conclusion: EPO therapy in conjunction with iron, vitamin E and folic acid, stimulated erythropoiesis and significantly reduced the need for blood transfusion in AOP.

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