Background and Aims The aim of this study was to investigate the value of pro-adrenomedullin (pro-ADM), as a marker of neonatal sepsis while comparing it with conventional markers of infection in newborns.

Methods Subjects were stratified into three groups; proven sepsis (Group 1a) and clinical sepsis (Group 1b) and the control group (Group 2) consisted of gestational age and birth weight matched newborns. Sequential measurements of white blood cell (WBC) count, C-reactive protein (CRP), interleukin-6 (IL-6) and pro-ADM were compared between groups.

Results A total of 76 patients with neonatal sepsis (31 with proven sepsis and 45 with clinical sepsis) and 52 healthy controls were enrolled. Mean baseline serum levels of CRP, IL-6 and pro-ADM were significantly higher in both Group 1a and Group 1b compared to healthy controls (p<0.001 for both). Although mean baseline CRP and IL-6 levels were similar between groups, mean baseline pro-ADM level was higher in the proven sepsis group than the clinical sepsis group (p<0.001).

Conclusion This is the first clinical study to investigate the value of pro-ADM for the diagnosis of proven and clinical sepsis in a newborn cohort including preterm newborns. Use of pro-ADM in combination with other acute phase reactants such as CRP and IL-6 for the diagnosis and follow-up of patients with neonatal sepsis has high sensitivity and specificity.