***ECD*** maternal C-reactive protein as a predictor of neonatal sepsis

Systemic bacterial infection in the newborn has a significant impact on neonatal mortality and morbidity. Non-invasive prenatal markers of risk could be useful in the prediction and prevention of neonatal sepsis. We evaluated the association of maternal third-trimester serum level of C-Reactive Protein (CRP) with neonatal sepsis in a sample of infants in the JAKids pregnancy and birth cohort study. A population-based nested case-control design was used to identify cases and controls of neonatal sepsis from the subset of infants in the JAKids study whose mothers had serum archived in the early third trimester and who were admitted to newborn intensive care. Cases were 25 neonates with neonatal sepsis identified from hospital records. Controls were a random sample of 62 sepsis-free neonates matched to cases within three gestational age strata - <= 32 weeks, 33-36 weeks, and >= 37 weeks. Mothers of neonatal sepsis cases >= 37 weeks had significantly higher mean levels of maternal CRP protein than mothers of controls (11.0 mg/dL +/- 3.0 vs. 8.7 mg/dL +/- 5.9; p < .05). Differences in maternal CRP were not found in sepsis cases born <= 32 weeks (9.5 mg/dL +/- 4.2 vs 5.8 mg/dL +/- 4.0, p = .23) nor in sepsis cases born at 33-36 weeks (9.0 mg/dL +/- 3.6 vs 11.9 mg/dL +/- 7.8, p = .34). Maternal third-trimester C-reactive protein levels were elevated in mothers of term-born neonates with sepsis, but not in the mothers of preterm neonates with sepsis.