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Articles |
Divisions of
1
Neonatology and
2
Obstetrics, S. Camillo Hospital, 00152 Rome, Italy.
3
Institute of Experimental Medicine, National Research
Council, 00161 Rome, Italy.
a Address correspondence to this author at: Institute of Pediatrics, La Sapienza University of Rome, Viale R. Elena, 324 00161 Rome, Italy. Fax 39-06-49-218-480; e-mail Claudio.Chiesa{at}Uniroma1.it
Background: The reported sensitivities and specificities of
procalcitonin (PCT) concentrations for the diagnosis of neonatal
infection vary widely. A postnatal increase of PCT has been observed in
healthy term newborns with a peak at 
24 h of age, and many questions
remain regarding maternal and perinatal factors that may influence the
normal PCT kinetics during the immediate postnatal period.
Methods: We prospectively investigated the association between the serum PCT values obtained from 121 mothers at delivery and serum PCT in their healthy, term offspring at birth as well as at 24 and 48 h of age. We also analyzed whether obstetric and perinatal factors would alter maternal and neonatal PCT response.
Results: PCT concentrations in the babies at birth were
significantly higher than in the mothers (P
<0.0001), with even larger differences at 24 and 48 h of age.
None of the variables identified from maternal and perinatal histories
had a significant effect on maternal PCT response. In the healthy
neonate, the variables that significantly affected the concentration of
PCT at birth were the mothers’ PCT (P <0.01), maternal
group B streptococcus colonization (P <0.05), and
rupture of membranes 
18 h (P <0.01). The coefficient
of linear correlation between the mother’s PCT concentration and that
of the baby at birth was 0.32 (P <0.01). The only
variable that significantly altered the PCT concentration at both 24
(P <0.01) and 48 (P <0.01) h of age was
rupture of membranes 18 h. Nonetheless, the PCT response observed
during the 48-h period after birth among healthy babies born to mothers
with risk factors for infection was well below that reported previously
among age-matched neonates with sepsis.
Conclusions: The postnatal increase of PCT observed in the healthy neonate with peak values at 24 h of age most likely represents endogenous synthesis. In estimating the sensitivities and specificities of PCT for diagnosis of sepsis throughout the initial 48 h of life, it is important to consider the normal PCT kinetics and the pattern(s) of PCT response in the healthy neonate.
The following articles in journals at HighWire Press have cited this article:
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  D Turner, C Hammerman, B Rudensky, Y Schlesinger, C Goia, and M S Schimmel Procalcitonin in preterm infants during the first few days of life: introducing an age related nomogram Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2006; 91(4): F283 - F286. [Abstract] [Full Text] [PDF]
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 S. D. Carrigan, G. Scott, and M. Tabrizian Toward Resolving the Challenges of Sepsis Diagnosis Clin. Chem., August 1, 2004; 50(8): 1301 - 1314. [Abstract] [Full Text] [PDF]
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C. Chiesa, A. Panero, J. F. Osborn, A. F. Simonetti, and L. Pacifico Diagnosis of Neonatal Sepsis: A Clinical and Laboratory Challenge Clin. Chem., February 1, 2004; 50(2): 279 - 287. [Full Text] [PDF]
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C. Chiesa, G. Pellegrini, A. Panero, J. F. Osborn, F. Signore, M. Assumma, and L. Pacifico C-Reactive Protein, Interleukin-6, and Procalcitonin in the Immediate Postnatal Period: Influence of Illness Severity, Risk Status, Antenatal and Perinatal Complications, and Infection Clin. Chem., January 1, 2003; 49(1): 60 - 68. [Abstract] [Full Text] [PDF]
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M. Ishibashi, Y. Takemura, H. Ishida, K. Watanabe, and T. Kawai C-Reactive Protein Kinetics in Newborns: Application of a High-Sensitivity Analytic Method in Its Determination Clin. Chem., July 1, 2002; 48(7): 1103 - 1106. [Full Text] [PDF]
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