In order to assess the role of tumor necrosis factor （TNF） in neonatal sepsis

plasma TNF levels were determined by a method using L929 cells at the time of septic work-up in 67 neonates. Thirty-three patients

with sepsis were found to have significantly higher TNF levels （533. 33 ±468. 74 U/ml ; 1 U corresponding to 1. 67 pg recombinant TNF） as compared with 34 non-sepsis patients （100. 0±188

97 U/ml） and 30 healthy newborns （27. 33±1 6. 1 7 U/ml

P<0. 05. respectively） . The upper limit of normal plasma TNF levels was 60 U/ml and the best cutoff value for predicting neonatal sepsis was 160 U/ml. This had remarkable sensitivity （88%）

specificity （82%）. positive predictive value （83%）. and negative predictive value （88%）. Plasma TNF levels were significantly associated with the occurrence of shock

organ failure. sclerema and outcome. Thus

anti-TNF antibodies might be used in protecting newborns from septic death.