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Umbilical Cord Blood IgA Levels and Bacterial Profile in Preterm Neonates Born with Maternal Risk Factors for Early-Onset Neonatal Sepsis

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To investigate the IgA levels and bacterial profile in umbilical cord blood (UCB) samples of mothers with risk factors compared to those without risk factors; and to understand the link between UCB culture positivity and neonatal outcomes [early-onset sepsis (EOS) or death within 7 d of life].

Methods

This is a pilot prospective case-control study. Mothers with preterm deliveries (gestational age <34 wk) were enrolled in two groups- Cases: Those with antenatal risk factors (prolonged duration of rupture of membranes of ≥24 h or chorioamnionitis) and controls: Those without these two risk factors. Serum IgA levels was assayed and microbiological culture was tested in UCB samples. 16S sequencing to determine the UCB microbiome was performed in a subset of samples (n = 15). Neonates were followed-up for the occurrence of EOS or death until 7 d of life.

Results

Forty-nine mothers as cases and 50 mothers as controls were consecutively enrolled. No significant difference was observed in the IgA levels (60.5 vs. 58.1 mg/L; p = 0.71), neonatal blood culture positivity (4.1% vs. 8.0%; p = 0.41) and UCB culture positivity (30.6% vs. 26.0%; p = 0.61) in the two groups. No difference was observed between the groups in occurrence of EOS or death within 7 d of life. Proteobacteria, Firmicutes and Actinobacteria were the most abundant phyla. Serratia, Bifidobacterium, Collinsella, Meganomas and Blautia being the most common genera.

Conclusions

Cord blood IgA concentration could not differentiate the neonates at-risk of infection due to its presence in both the groups.

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Acknowledgements

The authors acknowledge Research Section, AIIMS, New Delhi to approve the research grant for the study. The authors are immensely appreciative of all the mothers who gave their consent to participate in the study.

Funding

This work was funded by Research Section, AIIMS, New Delhi.

Author information

Authors and Affiliations

  1. Department of Neonatology, Central Health Service, Maulana Azad Medical College, (University of Delhi), Govt. of India, New Delhi, India

    Ashish Jain

  2. Department of Pediatrics, WHO Collaborating Centre for Education and Research in Newborn Health, Newborn Health Knowledge Centre, All India Institute of Medical Sciences, New Delhi, 110029, India

    Kajal Jain, Divashree Jhurani, Akash Sharma, M. Jeeva Sankar & Ramesh Agarwal

  3. Department of Gastroenterology, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    Asha Mishra

  4. Department of Microbiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    Sarita Mohapatra

  5. Department of Microbiology, Central Health Service, Maulana Azad Medical College, (University of Delhi), Govt. of India, New Delhi, India

    Vikas Manchanda

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  1. Ashish Jain
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Contributions

AJ, KJ, RA: Designed the study and prepared the manuscript; KJ, AJ, AM, VM: Implemented the study; KJ, DJ: Did data cleaning and statistical analysis; KJ, AJ, MJS, AS, SM, RA, DJ: Supervised the implementation of the study and finalized the manuscript. RA will act as the guarantor of the paper.

Corresponding author

Correspondence to Kajal Jain.

Ethics declarations

Ethics Approval

Ethics clearance was obtained from the ethics committee of AIIMS, New Delhi (IEC-407/04.08.2017; RP-13/2017) and MAMC, New Delhi (F.1/IEC/MAMC/59/04/2017/ No.169).

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Jain, A., Jain, K., Jhurani, D. et al. Umbilical Cord Blood IgA Levels and Bacterial Profile in Preterm Neonates Born with Maternal Risk Factors for Early-Onset Neonatal Sepsis. Indian J Pediatr 91, 541–547 (2024). https://doi.org/10.1007/s12098-023-04708-4

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