Academic Editor: Luca Roncati
Background: Procalcitonin can effectively differentiate between
bacterial sepsis and a systemic inflammatory response syndrome of noninfectious
origins in the adult. However, the usefulness of procalcitonin in perinatal field
is not determined. Thus, the purpose of this study was to determine whether
procalcitonin levels in the umbilical blood reflect the severity of
chorioamnionitis and to assess their correlation with perinatal outcomes.
Methods: A retrospective study was conducted in 145 pregnant women with
singleton pregnancies and their neonates at a tertiary center between September
2010 and March 2013. Procalcitonin levels in the umbilical blood were measured by
an immunoluminometric assay. The severity of chorioamnionitis was classified by
the histological stage and grade for maternal and fetal inflammatory responses.
Procalcitonin levels were evaluated according to the severity of
chorioamnionitis; and the association with neonatal sepsis, intraventricular
hemorrhage (IVH), neonatal death within 28 days of life, and periventricular
leukomalacia was investigated. Results: In total, 28 women (19%) had
chorioamnionitis, of which 21 (75%) delivered at less than 34 weeks of
gestation. Fetal response in those with chorioamnionitis was correlated with
maternal response. Procalcitonin levels in the group with fetal stage 2 and 3 or
grade 2 responses were significantly higher than those infants with any other
stage or grade. The frequency of neonatal sepsis, IVH stage III or IV, and
neonatal death significantly increased (p