Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes?
BACKGROUND
This study is aimed at comparing the early diagnostic accuracy of maternal blood white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin in predicting early onset neonatal sepsis (EONS) among early preterm premature rupture of membrane (PPROM) pregnancies.


METHODS
A total of 57 consecutive pregnancies, complicated with PPROM, between 24 and 34 gestational weeks were recruited to the study at Suleymaniye Maternity Education and Research Hospital, Istanbul, Turkey between January 2012 and January 2013. All patients were hospitalized and followed up with expectant management. Maternal blood WBC count, CRP and procalcitonin levels were measured in the first 12 h of membrane rupture. EONS was diagnosed using clinical and laboratory findings, and obstetric and neonatal outcomes were noted.


RESULTS
The cutoff value for maternal blood CRP was ≥9.49 mg/dl. This value predicted EONS with 77.8% sensitivity, 80.0% specificity, 77.8% positive predictive value (PPV) and 80.0% negative predictive value (NPV). The cutoff value for maternal blood procalcitonin was 0.071 ng/ml. This value predicted EONS with 85.2% sensitivity, 86.7% specificity, 85.2% PPV and 86.7% NPV.


CONCLUSIONS
Maternal blood procalcitonin levels were superior to maternal blood CRP and WBC count in predicting EONS. Consequently, the maternal blood procalcitonin level is a clinically useful, non-invasive and reliable biomarker in antenatal prediction of EONS.
Department of Obstetrics and Gynecology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.
Orkun
O
Cetin
Zuhal Dilek
ZD
Aydın
Fatma Ferda
FF
Verit
Ali Galip
AG
Zebitay
Erbil
E
Karaman
Sadi
S
Elasan
Mehtap
M
Turfan
Oguz
O
Yucel
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D006801:Humans; D007958:Leukocyte Count; D000071074:Neonatal Sepsis / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D055815:Young Adult
D002116:Calcitonin; D002097:C-Reactive Protein