Red Cell Distribution Width as a Novel Predictor of Neonatal Sepsis: A Cross-Sectional Study

Neonatal sepsis remains a leading cause of morbidity and mortality among neonates in India, exacerbated by unhealthy environments and low socioeconomic conditions. Early diagnosis and treatment are crucial to prevent severe outcomes, yet current diagnostic methods are often slow and influenced by various factors. This study evaluates the utility of red cell distribution width (RDW) as a diagnostic marker for neonatal sepsis, comparing its efficacy with traditional markers of neonatal sepsis–like white blood cell count, I/T ratio, ANC, micro ESR, and C-reactive protein (CRP). A hospital-based cross-sectional observational study was conducted in the Neonatal Division of Dr. S. N. Medical College, Jodhpur, Rajasthan, from June to December 2022. A total of 330 term neonates diagnosed with definite or probable sepsis were enrolled. Data on demographic details, clinical parameters, and laboratory results were collected, and RDW was measured using a Sysmex automatic analyzer. Statistical analysis was performed using PSPP, with significance set at p < 0.05. The study’s findings showed that 53.6% of the neonates had abnormal RDW (> 18). Significant associations were found between elevated RDW and other hematological parameters such as leukopenia, thrombocytopenia, increased I/T ratio, decreased absolute neutrophil count, elevated CRP, and micro ESR (p < 0.05). The findings suggest that elevated RDW is a significant marker for neonatal sepsis with a sensitivity of 76.06% and a specificity of 63.30% and correlates with disease severity. RDW, a readily available and cost-effective marker, can be effectively incorporated into routine diagnostics for early and accurate management of neonatal sepsis, especially in resource-limited settings. This study underscores the potential of RDW as a critical tool in improving neonatal healthcare outcomes.