Abstract
Neonates are highly susceptible to infection given their immature immune system. Previous studies on proteins related to neonatal infection mainly focused on certain antibodies or proteins, but without comprehensive studies on multiple immune-response-related proteins associated with neonatal infection. We conducted a nested case-control study within SZBBTwin cohort, 92 immune-response-related proteins in cord plasma of 149 twins (including 34 discordant twin pairs) were measured by proximity extension assay. All twins were followed for diagnoses of infection from birth until 27 days of age. Wilcoxon rank-sum test was used to determine differentially expressed proteins (DEPs), the predictive performance was evaluated by receiver operating characteristic curve, and their functions and pathways were annotated through enrichment analysis. Logistic regression was used to assess the associations between level of proteins and risk of neonatal infection. Five DEPs (ITGA11, FCRL6, DDX58, SH2D1A, and EDAR) were identified for neonatal infection, and the area under curve achieved 0.835, which were mainly enriched in the NF-κB pathway. A higher level of ITGA11 was associated with an increased risk of neonatal infection in both all twins and discordant twin pairs. This study suggests that multiple immune-response-related proteins in cord plasma, particularly ITGA11, are associated with neonatal infection in twins.