Assumma M, Signore F, Pacifico L, Rossi N, Osborn J F, Chiesa C
Divisions of Neonatology and Obstetrics, S. Camillo Hospital, 00152 Rome, Italy.
Clin Chem. 2000 Oct;46(10):1583-7.
The reported sensitivities and specificities of procalcitonin (PCT) concentrations for the diagnosis of neonatal infection vary widely. A postnatal increase of PCT has been observed in healthy term newborns with a peak at approximately 24 h of age, and many questions remain regarding maternal and perinatal factors that may influence the normal PCT kinetics during the immediate postnatal period.
We prospectively investigated the association between the serum PCT values obtained from 121 mothers at delivery and serum PCT in their healthy, term offspring at birth as well as at 24 and 48 h of age. We also analyzed whether obstetric and perinatal factors would alter maternal and neonatal PCT response.
PCT concentrations in the babies at birth were significantly higher than in the mothers (P <0.0001), with even larger differences at 24 and 48 h of age. None of the variables identified from maternal and perinatal histories had a significant effect on maternal PCT response. In the healthy neonate, the variables that significantly affected the concentration of PCT at birth were the mothers' PCT (P <0.01), maternal group B streptococcus colonization (P <0.05), and rupture of membranes >/=18 h (P <0.01). The coefficient of linear correlation between the mother's PCT concentration and that of the baby at birth was 0. 32 (P <0.01). The only variable that significantly altered the PCT concentration at both 24 (P <0.01) and 48 (P <0.01) h of age was rupture of membranes >/=18 h. Nonetheless, the PCT response observed during the 48-h period after birth among healthy babies born to mothers with risk factors for infection was well below that reported previously among age-matched neonates with sepsis.
The postnatal increase of PCT observed in the healthy neonate with peak values at 24 h of age most likely represents endogenous synthesis. In estimating the sensitivities and specificities of PCT for diagnosis of sepsis throughout the initial 48 h of life, it is important to consider the normal PCT kinetics and the pattern(s) of PCT response in the healthy neonate.
降钙素原（PCT）浓度用于诊断新生儿感染的报道敏感性和特异性差异很大。健康足月儿出生后PCT会升高，在出生后约24小时达到峰值，关于可能影响出生后即刻正常PCT动力学的母体和围产期因素仍存在许多问题。
我们前瞻性研究了121名母亲分娩时的血清PCT值与其健康足月儿出生时、出生后24小时和48小时的血清PCT之间的关联。我们还分析了产科和围产期因素是否会改变母体和新生儿的PCT反应。
婴儿出生时的PCT浓度显著高于母亲（P<0.0001），在出生后24小时和48小时差异更大。从母体和围产期病史中确定的变量均对母体PCT反应无显著影响。在健康新生儿中，出生时显著影响PCT浓度的变量是母亲的PCT（P<0.01）、母体B族链球菌定植（P<0.05）和胎膜破裂≥18小时（P<0.01）。母亲的PCT浓度与婴儿出生时的PCT浓度之间的线性相关系数为0.32（P<0.01）。唯一在出生后24小时（P<0.
