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Updated: Apr 26, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Low mannose-binding lectin (MBL) levels and MBL genetic polymorphisms associated with the risk of neonatal sepsis: An
Jun Luo1, Fen Xu2, Guang-Jin Lu2
1Department of Neonatology, BaYi Children's Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital of Southern Medical University, Beijing, China; Department of Neonatology, Bao'an Maternity and Child Health Hospital of Shenzhen, Guangdong, China.
Background:
Relatively low serum mannose-binding lectin (MBL) levels and MBL genetic polymorphisms have been implicated as high risk factors for neonatal sepsis. However, different studies have reported conflicting findings and have generally been underpowered to exclude modest effect sizes.
Methods:
Standard methodology of systematic reviews and meta-analyses was followed. PubMed, Embase, Cochrane, Web of Science, and Scopus databases were searched from January 1996 to December 2013. The eligible studies were collected and analyzed using Review Manager 5.2. Meta-Disc version 1.4 was used to describe and calculate sensitivity, specificity, summary receiver operator characteristic (SROC) curves and area under the curve. SROC curve analysis was used to summarize the overall performance. Funnel plots, Egger's test and Begg's test were used to investigate publication bias.
Results:
Seven studies addressing low MBL levels and MBL genetic polymorphisms (structure variant A/O, A/B of Exon1) were analyzed for susceptibility to neonatal sepsis, respectively. All of these control studies were of reasonable methodological quality. The pooled unadjusted odds ratio showed that low MBL levels were significantly associated with neonatal sepsis (P=0.0002; odds ratio=4.94, 95% confidence interval=2.16-11.29) and MBL genetic polymorphisms were also significantly associated with neonatal sepsis (P=0.03; odds ratio=1.41, 95% confidence interval=1.03-1.94). In subgroup analysis based on gestational age, increased risk was found in the preterm infants in the dominant model (RR 2.33, 95%CI 1.06-5.13, P=0.03). However, no association was observed for term infants in subgroup analysis. Additionally, the SROC curve of low MBL levels in the prediction of neonatal sepsis indicated a poor predictive ability. The area under curve was 0.80 (95% confidence interval=0.74-0.86).
Conclusion:
Currently available evidence shows that neonates with low serum MBL levels are more than four times more likely to have neonatal sepsis compared to those with higher serum MBL levels. Neonates with MBL genetic polymorphisms are also susceptible to developing neonatal sepsis. However, a low serum MBL level was only of moderate value in detecting neonatal sepsis.
Insights
Neonates with low mannose-binding lectin (MBL) levels are over four times more likely to develop neonatal sepsis. MBL genetic polymorphisms also increase sepsis risk, particularly in preterm infants.
Area of Science:
- Immunology
- Neonatal Medicine
- Genetics
Background:
- Low serum mannose-binding lectin (MBL) levels and MBL genetic polymorphisms are potential risk factors for neonatal sepsis.
- Previous studies have yielded conflicting results and lacked sufficient power to rule out modest effect sizes.
Purpose of the Study:
- To systematically review and meta-analyze the association between MBL levels/polymorphisms and neonatal sepsis risk.
- To evaluate the diagnostic performance of low MBL levels in predicting neonatal sepsis.
Main Methods:
- Systematic review and meta-analysis of seven studies published between January 1996 and December 2013.
- Searched PubMed, Embase, Cochrane, Web of Science, and Scopus databases.
- Analyzed data using Review Manager 5.2 and Meta-Disc 1.4, including SROC curve analysis and publication bias assessment.
Main Results:
- Low serum MBL levels significantly increased neonatal sepsis risk (OR=4.94).
- MBL genetic polymorphisms were also significantly associated with neonatal sepsis (OR=1.41).
- Increased risk was observed in preterm infants with MBL polymorphisms (RR=2.33), but not in term infants. The SROC analysis indicated poor predictive ability for low MBL levels (AUC=0.80).
Conclusions:
- Neonates with low serum MBL levels have a substantially higher risk of neonatal sepsis.
- MBL genetic polymorphisms contribute to neonatal sepsis susceptibility.
- Low serum MBL levels have moderate predictive value for neonatal sepsis.
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