Procalcitonin in preterm infants during the first few
days of life: introducing an age related nomogram
Dan Turner 1*, Cathy Hammerman 2, Bernard Rudensky 2, Yechiel Schlesinger 2, Cristina Goia 1 and Michael S. Schimmel 2
1 The Hospital for Sick Children, Canada
2 Shaare Zedek Medical Center, Israel
* To whom correspondence should be addressed. E-mail: turnerjd{at}rogers.com.
Accepted 22 February 2006
 | Abstract |
|---|
Objective: To determine normal values of
procalcitonin in preterm infants shortly after birth and
to assess its accuracy in detecting bacterial infection.
Methods: Blood samples of 100 preterm infants
were prospectively drawn during the first four days of
life for procalcitonin levels. Infants were classified
to four groups according to their infectious status.
Results: The infant's mean ± SD gestational age
and birth weight were 32 ± 2.9 weeks and 1682 ± 500
grams, respectively. 283 procalcitonin values from
healthy infants were plotted to construct nomograms of
physiologically elevated procalcitonin after birth,
stratified by two groups 24-30 and 31-36 weeks of
gestation. The peak 95th percentile procalcitonin value
was plotted at 28 hours of age and values return to
normal after four days of life. Only 12 infants were
infected and 13 of their 16 procalcitonin values drawn
after birth were higher than the 95th percentile, while
samples taken at birth were lower. In a multivariable
analysis, gestational age, premature rupture of membrane
and sepsis status influenced procalcitonin level
independently but maternal infection status did not.
Conclusions: The suggested preterm neonatal
nomograms are different than in term infants.
Procalcitonin levels exceeding the 95th percentile may
be helpful in detecting congenital infection, but not at
birth.
Keywords:
congenital infection, preterm newborns, procalcitonin, reference value
