A machine learning model for prediction of early-onset neonatal sepsis in low-income and middle-income countries: development and validation study Deepika Kainth, Ayushi Gupta, Pradeep Singh, Satya Prakash, Anu Thukral, Ashok Deorari, Mudit Kapoor, Ramesh Agarwal, Tavpritesh Sethi, M Jeeva Sankar BMJ Paediatrics Open, 2026 Objective Early-onset sepsis (EOS), which occurs within the first 72 hours of life, can often be fatal for neonates. Machine learning (ML) models demonstrate promise for timely diagnosis. However, current ML models primarily rely on data from high-income countries, which reduces their applicability to low-income and middle-income countries (LMICs) that have a higher burden and different disease profiles. We developed an ML model for the timely prediction of culture-proven EOS in LMICs. Methods We conducted a secondary analysis of the Delhi Neonatal Infection Study (2011–2014) carried out in three level-3 neonatal units in India. Data from inborn neonates suspected of having EOS were extracted, and cases of culture-negative sepsis were excluded. By implementing a dynamic 80:20 (train:test) data split, two feature selection methods were employed—Boruta and Lasso—across 64 variables, and five ML techniques were applied. The aim was to achieve 90% sensitivity to identify the optimal model based on performance metrics. The developed model was integrated into a web application and validated in an external cohort of neonates born between 2015 and 2021. Results Of 2924 neonates, 548 (18.7%) had culture-proven sepsis. The mean gestation and birth weight were 35.3 (±3.8) weeks and 2112 (±754) g, respectively. The Boruta and random forest classifier yielded the best model, which included 28 perinatal–neonatal variables. The sensitivity and specificity of the model were 90.3% and 40.6%, respectively. In external validation (n=147; 26 culture-proven sepsis cases), the model’s sensitivity, specificity, positive predictive value and negative predictive value were 92.3%, 37.2%, 24.0% and 95.7%, respectively. The sensitivity was 100% in asymptomatic neonates with only perinatal risk factors for EOS. The use of the model could have reduced antibiotic usage from 74.8% to 55.7% (risk difference: −19.1%; 95% CI −8.3 to −29.7). Conclusions The ML model demonstrated high sensitivity and acceptable specificity in predicting EOS. This prediction model has the potential to assist in the timely and reliable identification of culture-positive sepsis and may serve as a bedside decision support tool in LMICs.
Born Too Soon: learning from the past to accelerate action in the next decade Anna Gruending, Joy E. Lawn, Amy Reid, Etienne V. Langlois, Bo Jacobsson, Lori McDougall, Rajat Khosla, Zulfiqar A. Bhutta, Ashok K. Deorari, Lily Kak, Judith Robb-McCord, Nabila Zaka, Ditas Duque Decena, Helga Fogstad, Anshu Banerjee, Mary V. Kinney, Queen Dube Reproductive Health, 2025 Progress This paper is a narrative review that takes stock of the progress in addressing preterm birth over the past decade – notably on policies, national plans, innovation, evidence, social mobilisation, and community engagement – to inform future progress on preterm birth. At the global policy level, many countries have strongly supported collective initiatives and resolutions on maternal and newborn health relevant to preterm birth in multilateral fora, most recently through a World Health Assembly resolution calling for a revival amongst the global community on stalled progress for maternal, newborn and child health. Following the adoption of other global plans, like the Every Newborn Action Plan and Strategies for Ending Preventable Maternal Mortality, most countries set corresponding national mortality and coverage targets, and many have national and subnational policies and plans for integrated maternal and newborn health. Adequate financing remains a challenge, and sexual and reproductive health and rights of women and girls are being challenged globally. There have been significant advances in evidence-based interventions for preterm birth prevention and care, reflected in updated World Health Organization guidelines on antenatal, intrapartum and postpartum care, and care for small and sick newborns. The past decade has also seen progress in social mobilisation and community engagement, particularly parent groups and healthcare professional organisations advocating on issues surrounding preterm birth. Polycrisis and vulnerability There are, however, significant challenges that continue to hamper progress on preterm birth. Polycrisis – the interplay of overlapping economic, geopolitical, and environmental crises – compounds existing inequities, especially in places where health systems are already weak. Distinct and overlapping threats from conflict, climate change and the cost-of-living crisis present life-or-death challenges to those already facing extreme vulnerability, particularly women and girls, and small and sick newborns. Preterm birth: a marker of maternal and neonatal health progress in the coming decade The detrimental impacts of preterm birth are felt along the life course and across generations. The success of countries and the global community in preventing preterm births and ensuring high-quality care for mothers and preterm babies serves as a critical measure of progress – or failure – in advancing global efforts to improve maternal and newborn health.
Development of Multimodal Training Tool for Preterm Infant Care Anu Thukral, Vaishnavi Gupta, Deepak Chawla, Praveen Kumar, Ashok K Deorari, , Kumutha Kumaraswami, Ruchi Nanavati, Jayshree Mondkar, Geeta Gathwala, Soman Rao, Manglala Bharathi, Ramesh Agarwal, Sushma Nangia, Sandeep Kadam, M Jeeva Sankar, Rhishikesh Thakre, Tejopratap O, Ashish Jain, Nishad Plakkal, Reeta Bora, S Venkataseshan, Shiv Sajan Saini, Aparna C, Naveen Jain, Srinivas Murki, Sindhu Sivanandan, Amanpreet Sethi, N Chandra Kumar, Shridhar Goplakrishnan, Kanan Venkatnarayanan, Neeraj Gupta, Parijat Chandra, Madhumati Bose, Kavita Sreekumar, Jagjit Dalal, Meena Joshi, Jessy Shaji Paul, Kiran Singh, Baby Mondal, Asim Mallick, Bijan Saha, Parul Datta, Pratima Anand, Ashutosh Kumar, SS Bisht, Ravi Sachan, Lallan Bharati, Pankaj Mohanty, Prashantha YN, Shashidhar A, Sourabh Dutta, Suksham Jain, Vishal Guglani, Sant Lal, Puneet, Sandeep, Sahil, Swati Sharma, Savita Sharma, Meenakshi, Rajni Pathak Indian Journal of Pediatrics, 2025
Optimising Indian healthcare delivery with standard treatment workflows Ashoo Grover, Jerin Jose Cherian, Saumya Srivastava Aggarwal, Deepika Pandhi, Umesh Devappa Suranagi, Anjali Bajaj, Nikhil Tandon, Sudha Chandrashekar, Roderico Ofrin, Ashok Deorari, Atul Goel Clinical Epidemiology and Global Health, 2024
Mutation spectrum and enzyme profiling of G6PD deficiency in neonates of north India: a prospective study Upasana Bhattacharyya, Preeti Deswal, Sunil Kumar Polipalli, Diksha Sharma, Manpreet Kaur, Madhulika Kabra, Neerja Gupta, Ramesh Agarwal, A. K. Deorari, V. K. Paul, Shevendru Roy, R. K. Sanjeev, R. S. Tomar, J. S. Bhasin, Amit Tyagi, V. K. Sharma, Anil Gulati, Rajesh Yadav, M. M. A. Faridi, Prerna Batra, Pooja Dewan, Veena Devgan, Alka Mathur, Aseem Bhatnagar, Sunita Bhatia, Ajay Kumar, Sushma Nangia, Arvind Saili, Anju Seth, Deepak Singla, S. K. Arora, S. Mehndiratta, Ashish Jain, Gaurav Pradhan, Sangeeta Gupta, Siddarth Ramji, Mukesh Darshan, S. K. Polipalli, Somesh Kumar, Biju Varughese, Avinash Lomash, Poonam Sidana, Sonia Mitta, Amarjeet Chitkara, Arti Maria, Harish Chellani, K. C. Aggarwa, Shobhna Gupta, Arya Sugandha, Ajay Gambhir, Surinder Bisht, Anand Aggarwal, P. M. Kohli, Indermeet Singh, Seema Kapoor, B. K. Thelma, and Journal of Genetics, 2023
Noninvasive Respiratory Support for Newborns Aparna Chandrasekaran, Ashok K. Deorari (Chairperson), Neeraj Gupta, Srinivas Murki, M. Jeeva Sankar, Sindhu Sivanandan Journal of Neonatology, 2020
Screening and Management of Retinopathy of Prematurity Parijat Chandra, Deepak Chawla (Chairperson), Ashok K. Deorari, M. R. Dogra, Subhadra Jalali, Praveen Kumar, Amanpreet Sethi, Anand Vinekar Journal of Neonatology, 2020
Alarming rates of antimicrobial resistance and fungal sepsis in outborn neonates in North India Mamta Jajoo, Vikas Manchanda, Suman Chaurasia, M. Jeeva Sankar, Hitender Gautam, Ramesh Agarwal, Chander Prakash Yadav, Kailash C. Aggarwal, Harish Chellani, Siddharth Ramji, Monorama Deb, Rajni Gaind, Surinder Kumar, Sugandha Arya, Vishnubhatla Sreenivas, Arti Kapil, Purva Mathur, Reeta Rasaily, Ashok K. Deorari, Vinod K. Paul, Investigators of the Delhi Neonatal Infection Study (DeNIS) collaboration, New Delhi, India Plos One, 2018
Mobile-based Applications for Newborn Care Indian Pediatrics, 2017
Correspondence Anu Thukral, Ashok K. Deorari, Francesco Raimondi, Fiorella Migliaro, Chandra Rath, Pradeep Suryawanshi, Tamoghna Biswas, Subhabrata Majumdar, Paul T. Francis, Nimitha Paul Indian Pediatrics, 2017
Count every newborn; A measurement improvement roadmap for coverage data Sarah G Moxon, Harriet Ruysen, Kate J Kerber, Agbessi Amouzou, Suzanne Fournier, John Grove, Allisyn C Moran, Lara ME Vaz, Hannah Blencowe, Niall Conroy, A Metin Gülmezoglu, Joshua P Vogel, Barbara Rawlins, Rubayet Sayed, Kathleen Hill, Donna Vivio, Shamim A Qazi, Deborah Sitrin, Anna C Seale, Steve Wall, Troy Jacobs, Juan Gabriel Ruiz Peláez, Tanya Guenther, Patricia S Coffey, Penny Dawson, Tanya Marchant, Peter Waiswa, Ashok Deorari, Christabel Enweronu-Laryea, Shams El Arifeen, Anne CC Lee, Matthews Mathai, Joy E Lawn BMC Pregnancy and Childbirth, 2015
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Iron stores in low and normal birth weight infants at birth and in early infancy Investigators of LBW Micronutrient Study Group, Ramesh Agarwal, Deenanath Virmani, Munnalal Jaipal, Shuchita Gupta, Mari Jeeva Sankar, Sunita Bhatia, Anand Agarwal, Veena Devgan, Nandita Gupta, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2014
Vitamin D status of low birth weight infants in Delhi: A comparative study R. Agarwal, D. Virmani, M. L. Jaipal, S. Gupta, N. Gupta, M. J. Sankar, S. Bhatia, A. Agarwal, V. Devgan, A. Deorari, V. K. Paul, Investigators of LBW Micronutrient Study Group, Departments of Pediatrics, Endocrinology Journal of Tropical Pediatrics, 2012
Retinopathy of prematurity Deepak Chawla, Ramesh Agarwal, Ashok Deorari, Vinod K. Paul, Parijat Chandra, Rajvardhan V. Azad Indian Journal of Pediatrics, 2012
Online learning in newborn health: A distance learning model National Medical Journal of India, 2012
Hypocalcemia in the newborn Ashish Jain, Ramesh Agarwal, M. Jeeva Sankar, Ashok Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2010
Hypoglycemia in the newborn Ashish Jain, Rajiv Aggarwal, M. Jeeva Sankar, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2010
Effect of sling application on efficacy of phototherapy in healthy term neonates with non-hemolytic jaundice: A randomized conrolled trial Indian Pediatrics, 2009
Follow-up of high risk neonates Pradeep Kumar, M. Jeeva Sankar, Savita Sapra, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Chronic lung disease in newborns M. Jeeva Sankar, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Congenital hypothyroidism Vandana Jain, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Parenteral nutrition Deepak Chawla, Anu Thukral, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Acute renal failure in neonates Sreeram Subramanian, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul, Arvind Bagga Indian Journal of Pediatrics, 2008
Perinatal HIV Sunil Saharan, Rakesh Lodha, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Retinopathy of prematurity Deepak Chawla, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Polycythemia in the newborn M. Jeevasankar, Ramesh Agarwal, Deepak Chawla, Vinod K. Paul, Ashok K. Deorari Indian Journal of Pediatrics, 2008
Hypoglycemia in the newborn Ashish Jain, Rajiv Aggarwal, M. Jeevasanker, Ramesh Agarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Apnea in the newborn Satish Mishra, Ramesh Agarwal, M. Jeevasankar, Rajiv Aggarwal, Ashok K. Deorari, Vinod K. Paul Indian Journal of Pediatrics, 2008
Vitamin K1 versus vitamin K3 for prevention of subclinical vitamin deficiency: A randomized controlled trial Indian Pediatrics, 2007
Clinico-epidemiological profile and predictors of severe illness in young infants (<60 days) reporting to a hospital in North India Indian Pediatrics, 2007
Postnatal corticosteroids for Chronic Lung Disease (CLD) Indian Pediatrics, 2007
Clinical significance of airways colonization with Ureaplasma urealyticum in premature (<34 wk) neonates Indian Journal of Medical Research, 2007
Continuous positive airway pressure - A gentler approach to ventilation Indian Pediatrics, 2004
Efficacy of Oral Phenobarbitone in Term "At Risk" Neonates in Decreasing Neonatal Hyperbilirubinemia: A Randomized Double-blinded, Placebo Controlled Trial Indian Pediatrics, 2004
Use of Cisapride (multiple letters) Indian Pediatrics, 2000
Non-invasive estimation of total serum bilirubin (multiple letters) Indian Pediatrics, 2000
A double-blind placebo-controlled study on prophylactic use of cisapride on feed intolerance and gastric emptying in preterm neonates Indian Pediatrics, 2000
Non-invasive estimation of total serum bilirubin by multi-wavelength spectral reflectance in neonates Indian Pediatrics, 2000
Symptomatic neonatal polycythemia: comparison of partial exchange transfusion with saline versus plasma. Indian Pediatrics, 1995
Assisted ventilation for hyaline membrane disease. Indian Pediatrics, 1995
One year outcome of babies with severe neonatal hyperbilirubinemia and reversible abnormality in brainstem auditory evoked responses. Indian Pediatrics, 1994
Three-year experience with neonatal ventilation from a tertiary care hospital in Delhi Indian Pediatrics, 1993
Effects of maternal labetalol on the newborn infant Indian Pediatrics, 1992
Stool electrolyte composition in relation to etiology in acute gastroenteritis Indian Pediatrics, 1982
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