Diagnostic Performance of Soluble Fms-Like Tyrosine Kinase-1 and Vascular Endothelial Growth Factor for Neonatal Sepsis: A Case-Control Study.

OBJECTIVE: To evaluate the diagnostic performance of soluble fms-like tyrosine kinase-1 (sFlt-1) and vascular endothelial growth factor (VEGF) as early biomarkers for neonatal sepsis, and to explore their association with length of hospital stay. METHODS: This single-center case-control study consecutively enrolled 93 neonates (48 culture-confirmed sepsis, 45 infection without sepsis, and no infection). Serum sFlt-1 and VEGF were measured at diagnosis using enzyme-linked immunosorbent assay (ELISA). Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC). RESULTS: Serum sFlt-1 and VEGF levels were significantly higher in the confirmed sepsis than in the infection without sepsis and no infection groups (P<0.01), and both biomarkers correlated with longer hospitalization (>10 vs. ≤10 days). ROC analysis showed strong diagnostic performance for sFlt-1 (AUC=0.89; 95% CI 0.808-0.904); at a cut-off of 73.61 pg/mL, sensitivity was 72.92% and specificity 88.89%. VEGF demonstrated an AUC of 0.934 (95% CI 0.863-0.975); at a cut-off of 113.4 pg/mL, sensitivity was 75.00% and specificity 88.89%. CONCLUSION: sFlt-1 and VEGF are significantly elevated in neonatal sepsis and show high early diagnostic accuracy, supporting their potential utility as early diagnostic biomarkers; multicenter validation is warranted.