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A nomogram to predict probable meningitis in very preterm and/or very low birth weight infants with early-onset

Xiaowei Sun1, Rui Jing2, Zihan Zhuang1

  • 1Department of Pediatrics, Qilu Hospital, Shandong University, No. 107, West Culture Road, Lixia District, Jinan City, Shandong Province, 250000, China.

BMC Pregnancy and Childbirth
|June 2, 2026
PubMed
Abstract

Insights

A new nomogram can predict probable meningitis in preterm infants with early-onset sepsis (EOS). This tool aids in risk stratification and prioritizing lumbar punctures for better infant outcomes.

Area of Science:

  • Neonatalogy
  • Infectious Diseases
  • Clinical Prediction Models

Background:

  • Probable meningitis is a significant complication in very preterm and/or very low birth weight (VLBW) infants with early-onset sepsis (EOS).
  • Diagnosis is challenging due to reliance on cerebrospinal fluid (CSF) abnormalities without culture confirmation.

Purpose of the Study:

  • To develop and validate a predictive model for probable meningitis in VLBW infants with EOS.
  • To identify key predictors for early risk stratification.

Main Methods:

  • Retrospective multicenter cohort study of infants with gestational age < 32 weeks and/or birth weight < 1500g.
  • Used Least Absolute Shrinkage and Selection Operator (LASSO) regression for predictor selection.
  • Developed a nomogram using multivariable logistic regression and validated its performance.

Main Results:

  • The final model included mode of delivery, blood lactate, C-reactive protein, and procalcitonin.
  • The nomogram demonstrated good discrimination (AUC 0.855) and calibration.
  • 88 out of 359 eligible infants were diagnosed with probable meningitis.

Conclusions:

  • The developed nomogram effectively predicts probable meningitis in preterm infants with EOS.
  • It can aid in early risk stratification and guide lumbar puncture decisions.
  • External validation is recommended prior to widespread clinical implementation.
Keywords:
Early-onset sepsisPrediction modelProbable meningitisVery low birth weightVery preterm infants

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