Serum Calcium Level as a Prognostic Factor in Full-Term Infants with Neonatal Sepsis

Abstract

Neonatal sepsis is a major cause of neonatal morbidity and mortality, and early prognostic markers remain needed. This study aimed to evaluate the association between serum calcium levels and clinical outcomes and to determine their potential prognostic relevance in full-term infants with neonatal sepsis. Full-term infants with neonatal sepsis in the intensive care unit of a tertiary hospital were enrolled in prospective cohort study; Sixty neonates were recruited. Serum calcium was measured at sepsis diagnosis by a colorimetric method and categorized as normocalcemia (≥8 mg/dL) or hypocalcemia (<8 mg/dL). They were followed until improvement or death. Calcium concentrations and outcomes were analyzed using Mann–Whitney U and categorical analyses. Normocalcemia was observed more frequently than hypocalcemia. Hypocalcemia was more frequent among infants who died than among those who improved. Median serum calcium was significantly lower in infants who died than in those who improved (8.30 vs. 8.70 mg/dL, p = 0.045). However, the categorical association between hypocalcemia and clinical outcome did not reach statistical significance. Lower serum calcium concentrations were associated with poorer clinical outcomes in full-term infants with neonatal sepsis, although categorical hypocalcemia was not independently associated with mortality. Serum calcium may serve as an adjunctive marker for early risk stratification, but its independent prognostic value requires confirmation in larger studies using serial and ionized calcium measurements.