Antenatal inflammatory markers as early warning tools for neonatal sepsis: implications for nursing practice in low-resource settings

Background. Early-onset neonatal sepsis (EONS) remains a leading cause of neonatal morbidity and mortality, particularly in low-resource settings. Maternal inflammation may play a crucial role in priming the neonatal immune response. This study investigated the predictive value of maternal and neonatal inflammatory biomarkers for neonatal sepsis.

Aim: To evaluate the predictive value of maternal and umbilical cord inflammatory biomarkers for early detection of early-onset neonatal sepsis.

Materials and Methods. A total of 117 mother-infant pairs comprising 82 neonates with sepsis and 35 non-septic neonates were enrolled. Maternal venous blood was collected at 37–39 weeks of gestation and umbilical cord blood at delivery. C-reactive protein (CRP), procalcitonin (PCT), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α) were quantified using ELISA. Neonates were monitored for 28 days for clinical or culture-confirmed sepsis. Diagnostic performance of biomarkers was assessed using ROC-analysis in one-factor models of logistic regression.

Results. Maternal and cord levels of CRP, PCT, IL-6, and TNF-α were significantly higher among neonates who developed EONS compared to non-septic infants. Maternal CRP and IL-6 demonstrated strong predictive ability, while cord CRP and PCT showed excellent diagnostic quality (AUC 0.90 and 0.88, respectively). Multivariate analysis identified maternal CRP and ANC visits in EONS.

Conclusion. Maternal and umbilical cord inflammatory markers, especially CRP and IL-6, provide clinically useful early indicators of EONS risk. Integrating maternal biomarker screening into routine antenatal assessment may facilitate earlier detection and intervention in resource-limited neonatal care settings.

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