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Postnatal increase of procalcitonin in premature newborns is enhanced by chorioamnionitis and neonatal sepsis
Author(s) -
Janota J.,
Stranák Z.,
Bělohlávková S.,
Mudra K.,
Šimák J.
Publication year - 2001
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2001.00912.x
Subject(s) - chorioamnionitis , procalcitonin , medicine , sepsis , neonatal sepsis , gastroenterology , cord blood , birth weight , obstetrics , gestational age , pregnancy , biology , genetics
To determine the influence of chorioamnionitis and neonatal sepsis on procalcitonin (PCT) levels in very‐low‐birth‐weight (VLBW) infants within the first week of life. PCT serum levels were measured in cord blood 1 h after delivery and on day 3 and day 7 of life. Chorioamnionitis and neonatal sepsis within the first week were monitored. Chorioamnionitis was present in eight of 37 patients (21·6%). PCT on day 3 was increased in both the ‘No chorioamnionitis’ (2·54 ng mL −1 , SEM 0·51) and ‘Chorioamnionitis’ (6·96 ng mL −1 , SEM 2·93) groups of VLBW infants compared with the 1st hour values (0·45 and 0·58 ng mL −1 SEM 0·07 and 0·11, respectively, P < 0·001) of the same patients. The postnatal gain was higher in the ‘Chorioamnionitis’ group ( P < 0·01). Neonatal sepsis was diagnosed (after exclusion) in 12 of 32 patients (37·5%). Mean values of maximum PCT in patients with and without sepsis were 8·41 ng mL −1 (SEM 1·87) and 3·02 ng mL −1 (SEM 1·38), respectively ( P < 0·05). Sensitivity to sepsis of PCT, ratio of immature to total neutrophils (I : T), and C‐reactive protein (CRP) were 75%, 50% and 25%, respectively. In the group of VLBW infants the PCT level within 72 h of delivery was markedly increased in patients with chorioamnionitis. Compared with I : T and CRP, PCT appears to be a more sensitive marker of neonatal sepsis.