title: Umbilical cord blood procalcitonin as a risk factor for mortality in very premature infants.
abstract: Fetal inflammatory response syndrome is implicated as a cause of fetal or neonatal injury. We analyzed the relationship between the procalcitonin umbilical cord blood level and neonatal outcome. A total of 237 preterms born in a level III perinatal medicine unit of a French university hospital were enrolled in a prospective observational study. Measurement of the procalcitonin umbilical cord blood level was performed at birth. After hospitalization, surviving infants were enrolled in the regional follow-up program. Outcome data were recorded on standardized questionnaires. The main outcome measures were neonatal mortality and impaired functional outcome at 2 years of corrected age. The terciles of procalcitonin levels were calculated. Preterm infants of the third tercile were defined as infants with elevated procalcitonin. Among the 237 infants, 13 (5.5%) died during the neonatal period, 20 (8.4%) were lost to follow-up, and 31 (13.1%) were classified as having an impaired functional outcome. After adjustment, elevated cord blood procalcitonin (>0.33 ng/ml) was significantly associated with an increase in mortality (adjusted odds ratio [aOR] = 8.3 [1.4-48]; p = 0.018), but not with the 2-year impaired functional outcome (aOR = 1.0 [0.4-2.5]; p = 0.93). Elevated umbilical blood cord procalcitonin concentration is an independent risk factor of mortality in preterm infants at less than 33 weeks' gestation.
authors.affiliation: Departement de Périnatologie, Hôpital Mère-Enfant, CHU de Nantes, Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Lautridou
authors.forename: P-Y
authors.initials: PY
authors.lastname: Ancel
authors.forename: E
authors.initials: E
authors.lastname: Launay
authors.forename: S
authors.initials: S
authors.lastname: Denizot
authors.forename: J-L
authors.initials: JL
authors.lastname: Orsonneau
authors.forename: J C
authors.initials: JC
authors.lastname: Roze
authors.forename: C
authors.initials: C
authors.lastname: Gras-Le Guen
mesh_terms: D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005602:France; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012307:Risk Factors; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000401:mortality*; D062606:Tertiary Care Centers; D016896:Treatment Outcome
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide