title: Umbilical cord blood procalcitonin level in early neonatal infections: a 4-year university hospital cohort study.
abstract: This article describes a study of procalcitonin (PCT) measured in cord blood as a discriminating marker of early-onset neonatal infection. This was a monocenter retrospective study with prospective collection of data including all babies born during the study period. Those presenting infection risk factors had PCT measurement. Three groups were defined: certainly infected, probably infected, and non-infected. A total of 12,485 newborns were included, 2151 had PCT measurement, and 26 were infected. Receiver operating curves of PCT determined 0.6 ng/ml as the best cut-off, with an area under the curve of 0.96 (CI 95% 0.95-0.98). Sensitivity, specificity, positive and negative predictive value and positive and negative likelihood ratios were 0.92 (range, 0.75-0.98), 0.97 (0.96-0.98), 0.28 (0.20-0.36), 0.99 (0.99-0.99), 32 (24-41) and 0.08 (0.02-0.3), respectively. Post-test probabilities were 28% (23-33) if the test was positive, and less than 0.001% (0-1.10(-5)) if the test was negative. Gestational age between 28 and 32 weeks (OR 4.4; range, 1.2-16.2) and pH at birth < 7.10 (OR 2.9; 1.1-7.4) were other independent factors of increasing PCT (p < 0.05). PCT measured in umbilical cord blood is reliable to detect early infected and non-infected newborns.
authors.affiliation: Département de Périnatologie, Hôpital Mère Enfant CHU Nantes, Nantes, 44 093, France. nicolas.joram@chu-nantes.fr
authors.forename: N
authors.initials: N
authors.lastname: Joram
authors.forename: J-B
authors.initials: JB
authors.lastname: Muller
authors.forename: S
authors.initials: S
authors.lastname: Denizot
authors.forename: J-L
authors.initials: JL
authors.lastname: Orsonneau
authors.forename: J
authors.initials: J
authors.lastname: Caillon
authors.forename: J-C
authors.initials: JC
authors.lastname: Rozé
authors.forename: C
authors.initials: C
authors.lastname: Gras-Le Guen
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis* / Q000473:pathology; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D015331:Cohort Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide