Procalcitonin Levels of Infants Admitted to the Neonatal Intensive Care Unit during the First 48 Hours of Life: A Prospective, Cohort Study

Abstract

Background: Procalcitonin has been advocated as a marker for bacterial infection in patients. With its fast reactive time and short half life, procalcitonin is useful in making clinical decisions and in following the disease process. Whether procalcitonin is a suitable marker for neonatal intensive care unit (NICU) patients deserves study. Purpose: This study was to investigate serum procalcitonin levels in normal newborn infants, and to examine if the procalcitonin level is affected by neonatal pathophysiological aberrations. Method: Inborn neonates admitted to the NICU of Chang Gung Children's Hospital between May to September 2003 were enrolled. Blood samples were collected at postnatal 0, 24, and 48 hours. Serum was collected immediately and stored under -20℃ until analysis. Procalcitonin concentration was determined with commercialized kits, and data were analyzed. Results: There were 92 babies enrolled during this study period. In normal preterm babies, serum procalcitonin levels were 0.26+0.33, 2.13+1.85 and 0.74+0.69 ng/ml at 0, 24, and 48 hours, respectively. There was no difference among babies of different gestational ages. In babies with maternal chorioamnionitis, serum procalcitonin levels were significantly higher than in normal preterm babies: 1.68+3.13, 19.68+18.84 and 5.68+5.98 ng/ml at 0, 24, and 48 hours, respectively (p＜0.05). However, their clinical assessment scores (SNAP, NTISS) did not show any differences when compared to normal newborns. Conclusion: The procalcitonin level does not change among neonates of different gestational ages. In infants of maternal chorioamnionitis, there is significant procalcitonin level elevation before differences can be identified by clinical evaluations.