BACKGROUND: Premature infants are at high risk of early-onset sepsis (EOS) relative to term infants, and most are administered empirical antibiotics after birth. We aimed to determine if factors evident at birth could be used to identify premature infants at lower risk of EOS. METHODS: Study infants were born at 00 to 00 weeks' gestation in Neonatal Research Network centers from 0000 to 0000. EOS was defined by isolation of pathogenic species from blood or cerebrospinal fluid culture at ≤00 hours age. Infants were hypothesized as 