Maternal prothrombin time may be an effective marker for neonatal sepsis risk stratification

1. Maternal prothrombin time measured at delivery was the only independent maternal laboratory predictor of neonatal sepsis in this cohort.

2. A maternal prothrombin time cutoff of 10.25 seconds showed high sensitivity and moderate specificity, suggesting possible utility as a screening adjunct at birth.

Evidence Rating Level: 2 (Good) 

This retrospective single-center case–control study evaluated whether maternal hemostatic and inflammatory markers measured at delivery could help predict neonatal sepsis. The authors included 176 newborns delivered between April 2022 and April 2025, of whom 37 developed neonatal sepsis within the first 72 hours of life, and 139 served as healthy controls. Maternal laboratory values assessed at delivery included white blood cell count, neutrophil-to-lymphocyte ratio, platelet count, prothrombin time, activated partial thromboplastin time, international normalized ratio, and several derived inflammatory indices. Compared with controls, mothers of neonates with sepsis had significantly higher prothrombin time, activated partial thromboplastin time, international normalized ratio, and systemic inflammation response index. However, on multivariable logistic regression, maternal prothrombin time was the only independent predictor of neonatal sepsis, with an odds ratio of 1.79. Receiver operating characteristic analysis showed that prothrombin time had the best diagnostic performance, with an area under the curve of 0.909. A cutoff of 10.25 seconds yielded a sensitivity of 89.2% and a specificity of 68.3%. The authors conclude that maternal prothrombin time is a readily available, low-cost marker with strong potential to support delivery-time neonatal sepsis risk stratification, although larger multicenter studies are needed for validation.

Click here to read this study in PLOS One

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