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Umbilical cord blood procalcitonin as a risk factor for mortality in very premature infants

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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.

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References

  1. Ancel PY, Marret S, Larroque B et al; Epipage Study Group (2005) Are maternal hypertension and small-for-gestational age risk factors for severe intraventricular hemorrhage and cystic periventricular leukomalacia? Results of the EPIPAGE cohort study. Am J Obstet Gynecol 193:178–184

    Article  PubMed  Google Scholar 

  2. Yoon BH, Jun JK, Romero R et al (1997) Amniotic fluid inflammatory cytokines (interleukin-6, interleukin-1beta, and tumor necrosis factor-alpha), neonatal brain white matter lesions, and cerebral palsy. Am J Obstet Gynecol 177:19–26

    Article  PubMed  CAS  Google Scholar 

  3. Duggan PJ, Maalouf EF, Watts TL et al (2001) Intrauterine T-cell activation and increased proinflammatory cytokine concentrations in preterm infants with cerebral lesions. Lancet 358:1699–1700

    Article  PubMed  CAS  Google Scholar 

  4. Bashiri A, Burstein E, Mazor M (2006) Cerebral palsy and fetal inflammatory response syndrome: a review. J Perinat Med 34:5–12

    Article  PubMed  Google Scholar 

  5. Goepfert AR, Andrews WW, Carlo W et al (2004) Umbilical cord plasma interleukin-6 concentrations in preterm infants and risk of neonatal morbidity. Am J Obstet Gynecol 191:1375–1381

    Article  PubMed  CAS  Google Scholar 

  6. Stocker M, Fontana M, El Helou S et al (2010) Use of procalcitonin-guided decision-making to shorten antibiotic therapy in suspected neonatal early-onset sepsis: prospective randomized intervention trial. Neonatology 97:165–174

    Article  PubMed  Google Scholar 

  7. Joram N, Muller JB, Denizot S et al (2011) Umbilical cord blood procalcitonin level in early neonatal infections: a 4-year university hospital cohort study. Eur J Clin Microbiol Infect Dis 30:1005–1013

    Article  PubMed  CAS  Google Scholar 

  8. Fily A, Pierrat V, Delporte V et al (2006) Factors associated with neurodevelopmental outcome at 2 years after very preterm birth: the population-based Nord-Pas-de-Calais EPIPAGE cohort. Pediatrics 117:357–366

    Article  PubMed  Google Scholar 

  9. Sices L, Stancin T, Kirchner L et al (2009) PEDS and ASQ developmental screening tests may not identify the same children. Pediatrics 124:e640–e647

    Article  PubMed  Google Scholar 

  10. Haque KN (2005) Definitions of bloodstream infection in the newborn. Pediatr Crit Care Med 6:S45–S49

    Article  PubMed  Google Scholar 

  11. Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis (2005) International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 6:2–8

    Article  PubMed  Google Scholar 

  12. Kallapur SG, Jobe AH (2006) Contribution of inflammation to lung injury and development. Arch Dis Child Fetal Neonatal Ed 91:F132–F135

    Article  PubMed  CAS  Google Scholar 

  13. Turner D, Hammerman C, Rudensky B et al (2006) Procalcitonin in preterm infants during the first few days of life: introducing an age related nomogram. Arch Dis Child Fetal Neonatal 91:F283–F286

    Article  CAS  Google Scholar 

  14. Lapillonne A, Basson E, Monneret G et al (1998) Lack of specificity of procalcitonin for sepsis diagnosis in premature infants. Lancet 351:1211–1212

    Article  PubMed  CAS  Google Scholar 

  15. Malin GL, Morris RK, Khan KS (2010) Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis. BMJ 340:c1471

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Professor Veronique Gournay for her help in preparing the manuscript.

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Authors and Affiliations

  1. Departement de Périnatologie, Hôpital Mère-Enfant, CHU de Nantes, Nantes, France

    A. Lautridou, E. Launay, S. Denizot, J. C. Roze & C. Gras-Le Guen

  2. National Institute of Health and Medical Research CIC004, Nantes University Hospital, Nantes, France

    A. Lautridou, S. Denizot, J. C. Roze & C. Gras-Le Guen

  3. Epidemiological Research on Perinatal Health and Women’s and Children’s Health, INSERM, UMR S953, IFR 69, 75020, Paris, France

    P.-Y. Ancel

  4. UPMC Univ Paris 06, UMR S953, 75005, Paris, France

    P.-Y. Ancel

  5. Biochemistry Laboratory, Nantes University Hospital, Nantes, France

    J.-L. Orsonneau

Authors
  1. A. Lautridou
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  2. P.-Y. Ancel
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  3. E. Launay
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  4. S. Denizot
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  5. J.-L. Orsonneau
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  6. J. C. Roze
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  7. C. Gras-Le Guen
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Corresponding author

Correspondence to C. Gras-Le Guen.

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Lautridou, A., Ancel, PY., Launay, E. et al. Umbilical cord blood procalcitonin as a risk factor for mortality in very premature infants. Eur J Clin Microbiol Infect Dis 31, 2407–2412 (2012). https://doi.org/10.1007/s10096-012-1583-0

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  • DOI: https://doi.org/10.1007/s10096-012-1583-0

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