[Concentration of procalcitonin in maternal blood, amniotic fluid and in umbilical cord blood as an indicator of neonatal infection].
THE AIM of this study was to evaluate the usefulness of determining the concentration of procalcitonin (PCT) in the blood of pregnant women, in amniotic fluid and in umbilical blood as a predictor of intrauterine or infant infection.


METHODS
the study was conducted on the following material: pregnant women s blood, amniotic fluid and umbilical blood taken during delivery from 60 women and 60 infants. In this group there were 30 vaginal deliveries and 30 deliveries by caesarean section. The PCT concentration was determined by an immunoluminometrical method (ILMA) using two antigen specific monoclonal antibodies; method sensitivity was 0.3 ng/ml. The determining precision was 5-10%. In statistical analysis the U Mann- Whitney test, chi square and ROC curve were employed. A p value less then 0.05 was considered as statistically significant.


RESULTS
statistically significant increase in concentration of PCT (p<0.049) was found in umbilical blood of infants whose mothers had intrauterine infection, while such a correlation was not found either in the pregnant women's blood nor in the amniotic fluid. The low levels of AUC indicators found in all analyzed systemic fluids indicate minor usefulness of PCT as an indicator allowing predictions of infant infections. PCT concentrations in the amniotic fluid in comparison with concentrations of PCT in pregnant women's blood and in umbilical blood showed the highest value as a predictor of infection in infants after delivery (respectively AUC - 0.599; 0.582; 0.545). However, low levels of indicator LR - 1.35 demonstrate a nonsignificant value of this indicator as a predictor of infection in infants independent of infection in pregnant women, infection in pregnant women and their infants, or premature delivery.


CONCLUSIONS
1. Clinical symptoms of infection in pregnant women are accompanied by increased concentration of PCT in the umbilical blood. 2. The absence of symptoms of infection in a pregnant woman, infection in infant or simultaneous infection in infant and pregnant woman is not a predictor of concentrations of PCT in pregnant woman blood, in amniotic fluid nor in umbilical blood. 3. Examining the concentration of PCT in blood of pregnant women, in amniotic fluid and in umbilical blood is not a clinically useful indicator predicting intrauterine infection in infant.
Plonka
Tomasz
T
Klinika Medycyny Matczyno-Plodowej, Pomorska Akademia Medyczna, ul. Unii Lubelskiej 1, Szczecin, Poland. tomp71@o2.pl
Bilar
Marek
M
Sipak-Szmigiel
Olimpia
O
Ronin-Walknowska
Elzbieta
E
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D015415:Biomarkers / Q000032:analysis; D002116:Calcitonin / Q000032:analysis*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011498:Protein Precursors / Q000032:analysis*; D012680:Sensitivity and Specificity
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide