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Molecular detection of bacteria, placental inflammation, and neonatal sepsis risk



To identify bacteria in umbilical cord tissue and investigate the association with placental inflammation and neonatal sepsis risk score.

Study design

Retrospective cohort study from 2017–2019. RNA was extracted from umbilical cord tissue and NanoString nCounter used to identify seven bacteria genera. Sepsis risk score was calculated using the Kaiser sepsis calculator. Placental histopathology was abstracted from medical records.


Detection of bacterial RNA in the umbilical cord (n = 96/287) was associated with high-stage maternal and fetal acute placental inflammation (maternal 35.4% vs 22.5%, p = 0.03 and fetal 34.4% vs 19.4%, p < 0.01) and maternal vascular malperfusion (36.5% vs 23.0%, p = 0.02). Detection of Ureaplasma spp. was also associated with increased sepsis risk score (1.5/1000 [0.6, 8.6] vs 0.9/1000 [0.2, 2.9], p = 0.04).


Umbilical cord bacterial pathogens are linked to fetal and maternal placental inflammation and maternal vascular malperfusion during gestation and associated with increased sepsis risk score in the neonate.

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Fig. 1: Distribution of bacteria detected by NanoString in the sample.

Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due potential compromise of individual privacy, but are available from the corresponding author on reasonable request.


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This study was funded by the Auxiliary of NorthShore University HealthSystem (PI: Ernst).

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Authors and Affiliations



ADF assisted with data analysis and interpretation, gathered clinical data, drafted the initial manuscript, and reviewed and revised the manuscript. AF performed statistical analysis and reviewed and revised the manuscript. KW assisted with data analysis and interpretation and reviewed and revised the manuscript. KAM oversaw the RNA extraction and NanoString analysis, interpreted data, and reviewed and revised the manuscript. VW performed the sectioning and RNA extractions from the umbilical cord tissue and reviewed and revised the manuscript. EP assisted with patient selection, data collection, maintained the integrity of the study database and reviewed and revised the manuscript. LME conceptualized the study design, interpreted data, reviewed the placental histology, and reviewed and revised the manuscript. All authors approve the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Linda M. Ernst.

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The authors declare no competing interests.

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Franklin, A.D., Freedman, A., Wylie, K. et al. Molecular detection of bacteria, placental inflammation, and neonatal sepsis risk. J Perinatol (2023).

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