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Open research questions in Neonatal and Maternal Infections

62 unresolved questions extracted from the limitations and future-work sections of 339 Neonatal and Maternal Infections papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • The nonspecific nature of clinical signs and limited sensitivity of conventional microbiological methods hinder early diagnosis of neonatal sepsis. There is a need for novel biomarkers that can accurately diagnose neonatal sepsis.

    Evaluation of serum progranulin as a biomarker for early detection of neonatal sepsis in a microbiological context · 2026 · DOI

  • Early identification of critically ill neonates is essential for timely intervention and improved outcomes. Limited resources and lack of access to laboratory investigations and complex calculations can hinder the use of neonatal illness severity scoring systems.

    Modified Sick Neonatal Score in Predicting Outcomes of Neonates Admitted to the NICU at a Tertiary Care Center in Northern India · 2026 · DOI

  • Further studies are needed to validate the MSNS in different settings and populations. Studies can explore the use of the MSNS in conjunction with other scoring systems to improve predictive accuracy.

    Modified Sick Neonatal Score in Predicting Outcomes of Neonates Admitted to the NICU at a Tertiary Care Center in Northern India · 2026 · DOI

  • High rates of multidrug resistance among gram-negative bloodstream infections. Limited treatment options for multidrug-resistant gram-negative infections. Difficulty in empirical treatment selection due to high rates of resistance.

    Risk factors for multidrug resistance and mortality in healthcare-associated neonatal gram-negative bloodstream infections · 2026 · DOI

  • Clinical presentation in young infants is often nonspecific, making diagnosis challenging. UTIs can be associated with underlying structural or functional abnormalities of the urinary tract. There is a need for a multidisciplinary approach to optimize outcomes and prevent long-term renal damage.

    Sepsis of urinary origin in a young infant: a case report for pediatric practice · 2026 · DOI

  • Reduced access to antenatal care and infection control practices. Increased risk of neonatal sepsis due to displacement and conflict. Limited resources and infrastructure for healthcare services.

    NEONATAL SEPSIS AS AN INDICATOR OF INFECTIOUS BURDEN DURING WARTIME: DATA FROM LVIV REGION (2022–2024) · 2026 · DOI

  • High workload in the NICU. High sepsis rate among referred antenatal patients. Limited data on the impact of quality improvement-based programs on antibiotic use.

    Implementation of quality improvement principles for antimicrobial stewardship program in the level III B neonatal intensive care unit of a tertiary care public hospital · 2026 · DOI

  • There is a need to evaluate the efficacy of vancomycin catheter lock to prevent Gram-positive bloodstream infection in neonates. Prior studies have shown that vancomycin central venous catheter lock therapy can reduce catheter-associated infection, but more data are needed.

    Randomized controlled, double blind trial of use of vancomycin catheter-lock to prevent Gram-positive bloodstream infection in neonates · 2026 · DOI

  • There is a need for early and accurate identification of preterm infants at heightened risk for infection. The interpretation of inflammatory biomarkers can be challenging in preterm infants.

    Admission red cell distribution width–to–albumin ratio and risk of neonatal pneumonia or culture-proven sepsis in preterm infants: a retrospective cohort study · 2026 · DOI

  • Concerns about workload. Lack of confidence in clinical surveillance. Resistance to change.

    Serial clinical observation in early neonatal sepsis: insights from a national portuguese survey · 2026 · DOI

  • Probiotic regimens, however, are highly heterogeneous, and their mechanisms of action in the neonatal intestine are poorly defined, complicating efforts to design safe, effective, and regulatable interventions.

    Ecology of protection: probiotic biogeography and sepsis prevention in the neonatal intestine · 2026 · DOI

  • Conclusion Our integrated pipeline nominates FCER1G, IL1R2, and BST1 as biologically coherent biomarkers of sepsis and highlights BST1 as a plausible therapeutic target warranting further investigation.

    Integrated Bioinformatics Analysis Identifies <scp>FCER1G</scp> , <scp>IL1R2</scp> , and <scp>BST1</scp> as Diagnostic Biomarkers and Therapeutic Targets in Sepsis · 2026 · DOI

  • The effectiveness of intrapartum chemoprophylaxis in reducing the rate of transmission of group B streptococci was not well established. The optimal approach to intrapartum chemoprophylaxis was not well defined.

    The effect of intrapartum chemoprophylaxis on the vertical transmission of group B streptococci · 1983 · DOI

  • Rising rates of antimicrobial resistance. Difficulty in treating K. pneumoniae infections. Limited understanding of the genetic lineages associated with transmission clusters.

    Contribution of nosocomial transmission to Klebsiella pneumoniae neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data · 2026 · DOI

  • The fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission is unknown. The genetic lineages associated with transmission clusters are not well characterized.

    Contribution of nosocomial transmission to Klebsiella pneumoniae neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data · 2026 · DOI

  • Further research is needed to understand the emergence of multidrug-resistant lineages and hypervirulent genomic clones, such as ST283. Research should focus on developing effective preventive measures and strategies to mitigate the threat of invasive GBS infections in nonpregnant adults.

    Descriptive review: global spectrum of invasive group B streptococcal disease in nonpregnant adults: epidemiology, risk factors and clinical presentations · 2026 · DOI

  • Collective data on invasive group B streptococcal disease in nonpregnant adults remains fragmented. There is a need for further research on effective preventive measures and strategies.

    Descriptive review: global spectrum of invasive group B streptococcal disease in nonpregnant adults: epidemiology, risk factors and clinical presentations · 2026 · DOI

  • The immaturity of both innate and adaptive immunity in preterm infants contributes to their vulnerability to infection. Limited understanding of the early immune development of very PT infants.

    Immunophenotyping of very and extremely preterm infants at risk of developing sepsis and necrotising enterocolitis – a prospective, single-centre cohort study · 2026 · DOI

  • The study had a limited sample size of 30 very-low-birth-weight infants. A formal sample size calculation was not feasible due to the limited size of the population.

    Immunophenotyping of very and extremely preterm infants at risk of developing sepsis and necrotising enterocolitis – a prospective, single-centre cohort study · 2026 · DOI

  • There is a need for improved diagnostic tools and management strategies for neonatal sepsis. There is a lack of data on the long-term outcomes of neonates with sepsis. There is a need for more effective antimicrobial stewardship programs.

    Recognizing and managing neonatal sepsis · 2026 · DOI

  • There is a need to identify biomarkers that can predict the development of early-onset neonatal sepsis in preterm premature rupture of membranes. The current study aims to investigate the use of maternal serum procalcitonin as a predictor of EONS in PPROM.

    Maternal Serum Procalcitonin as a Predictor of Early-Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes: A Study in a Tertiary Care Hospital in Bangladesh · 2026 · DOI

  • Routine maternal serum procalcitonin measurement should be incorporated into PPROM management protocols. Large multicenter studies are needed to validate optimal cutoff values across different gestational ages and to establish PCTguided neonatal surveillance algorithms. REFERENCES 1. Sae‐Lin, Phatsorn, and Prapat Wanitpongpan. "Incidence and risk factors of preterm premature rupture of membranes in singleton pregnancies at Siriraj Hospital." Journal of Obstetrics and Gynaecology Research 45.3 (2019): 573- 577. 2. BIRTH, ASSOCIATED PRETERM. "DECIDUAL BLEEDING AND THROMBIN." Creasy and Resnik's Maternal-Fetal Medicine-E-Book: Principles and Practice (2022): 107. Eichberger, Julia, Elisabeth Resch, and Bernhard Resch. "Diagnosis of neonatal sepsis: the role of inflammatory markers." Frontiers in pediatrics 10 (2022): 840288. 3. 4. Sirivunnabood, Thitiporn, Prapat Wanitpongpan, and Piengbulan Yapan. "Incidence and risk factors of neonatal sepsis in preterm premature rupture of membranes before 34 weeks of gestation." Siriraj Medical Journal 74.3 (2022): 169-177. 6. 5. Ocviyanti, Dwiana, and William Timotius Wahono. "Risk factors for neonatal sepsis in pregnant women with premature rupture of the membrane." Journal of Pregnancy 2018.1 (2018): 4823404. Stoll, Barbara J., et al. "Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993- 2012." Jama 314.10 (2015): 1039-1051. Simonsen, Kari A., et al. "Early-onset neonatal sepsis." Clinical microbiology reviews 27.1 (2014): 21-47. 8. Altunhan, H. et al. "Procalcitonin 7. 9. measurement at 24 hours of age may be helpful in the prompt diagnosis of earlyonset neonatal sepsis." International Journal of Infectious Diseases 15.12 (2011): e854-e858. Pieralli, Filippo, et al. "Procalcitonin kinetics in the first 72 hours predicts 30- day mortality in severely ill septic patients admitted to an intermediate care unit." Journal of Clinical Medicine Research 7.9 (2015): 706. 10. Hahn, Won-Ho, et al. "Is procalcitonin to C-reactive protein ratio useful for the detection of late onset neonatal sepsis?" The Journal of Maternal-Fetal & Neonatal Medicine 31.6 (2018): 822-826. 11. Thornburg, Loralei L., et al. "Procalcitonin for prediction of chorioamnionitis in preterm premature rupture of membranes." The Journal of Maternal- Fetal & Neonatal Medicine 29.13 (2016): 2056-2061. 12. Oludag, Tülay, et al. "Value of maternal procalcitonin levels for predicting subclinical intra‐amniotic infection in preterm premature rupture of membranes." Journal of Obstetrics and Gynaecology Research 40.4 (2014): 954- 960. 13. Wirz, Yannick, et al. "Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in intensive care unit patients with infection and sepsis patients: a patient-level meta-analysis of randomized trials." Critical care 22.1 (2018): 191.

    Maternal Serum Procalcitonin as a Predictor of Early-Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes: A Study in a Tertiary Care Hospital in Bangladesh · 2026 · DOI

  • There is a need for a reliable and accurate tool to identify neonates requiring intensive care. The PSU-NEWS has the potential to fill this gap, but its performance needs to be evaluated.

    Predictive performance of the PSU-neonatal early warning score in identifying newborns requiring intensive care · 2026 · DOI

  • Limited understanding of the epidemiology of gram-negative bloodstream infections in neonatal intensive care units. Limited knowledge of the factors associated with multidrug resistance and 28-day mortality in this population.

    Risk factors for multidrug resistance and mortality in healthcare-associated neonatal gram-negative bloodstream infections · 2026 · DOI

  • Clinical and experimental data implicate Ureaplasma exposure in early lung inflammation, impaired alveolar development, and bronchopulmonary dysplasia (BPD), yet the pathogenic events preceding microbial invasion of the amniotic cavity or fetal tissues remain poorly defined.

    Choriodecidual Ureaplasma parvum infection induces fetal lung inflammation prior to intra-amniotic infection in a nonhuman primate model · 2026 · DOI

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62 open questions have been extracted from the limitations and future-work passages of 339 Neonatal and Maternal Infections papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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