In neonates, a higher immature-to-total neutrophil ratio is associated with infection risk.

• A. It indicates infection risk
• B. It indicates maturation and low infection risk
• C. No correlation with infection
• D. Only in term infants

Answer: (A)

A higher immature-to-total neutrophil ratio reflects a left shift, meaning the bone marrow is releasing more immature neutrophils in response to infection or inflammatory stress. In neonates, this elevation is a marker of infection risk and helps clinicians assess for sepsis, especially when the total neutrophil count isn’t clearly abnormal. It doesn’t indicate maturation with low risk, and it’s not limited to term infants; a higher I/T ratio can occur in preterm neonates as well when infection is present.