Procalcitonin is more likely to be released by the fetus rather than placental tissue during chorioamnionitis

Abstract

Aims. To analyze the relationship between maternal, cord blood and neonatal procalcitonin (PCT) levels in preterm deliveries with and without histologically proven chorioamnionitis (HCA). Methods. 91 mother-infant pairs from 24+0 to 33+0 gestational weeks were analyzed. Procalcitonin was measured in all mothers within 24 hours before and subsequently in cord blood and in neonates within the first two hours after delivery. PCT levels were analysed in relationship to HCA and clinical outcome. Results. HCA was confirmed in 28 cases (31%). We found no differences in PCT values between HCA positive and negative groups in maternal blood (0.1±0.1 vs 0.09±0.09 ng/L, P = 0.76). PCT values in cord blood and neonates were significantly higher in the HCA positive compared to HCA negative group (0.23±0.1 vs 1.2±2.7 ng/L, P < 0.001 and 0.89±3.4 vs 4.2±9.3 ng/L, P < 0.0001 respectively). PCT values in neonates were significantly higher than those of cord blood. Levels were not influenced by the mode of delivery, gestational age or premature rupture of membranes. Chorioamnionitis was more frequently associated with early onset neonatal sepsis (36% in HCA group vs 5% in non HCA group, P < 0.0001). Comparison of other clinical data revealed no differences between HCA positive and negative groups. Conclusion. This study showed higher PCT in cord and neonatal blood in the presence of proven histological chorioamnionitis. The measurement of PCT in mothers' blood is not helpful for diagnosis of HCA. The changes in PCT values shown suggest its production and release by fetal tissue.

Establishment of reference intervals for maternal blood and umbilical cord blood procalcitonin in healthy Chinese women in late pregnancy

“…found that the maternal blood PCT level in the vaginal delivery group was higher than that in the cesarean section group, which is contrary to the results of Paccolat et al .’s study . In the present study, we found that the delivery method did not affect umbilical cord blood PCT level, which indirectly indicated that umbilical cord blood PCT and maternal blood PCT came from different sources …”

“…PCT is highly sensitive and specific in the diagnosis of infection, and thus it is considered as a promising biochemical marker for early infection detection, inflammation estimation and prognosis prediction . maternal serum and neonatal cord blood PCT have been used by some researchers in intrauterine infection‐related studies . Chorioamnionitis (CA), which is an inflammation of fetal membranes, amniotic fluid, placenta and/or decidua, is the most common cause of intrauterine infection .…”

The diagnostic utility of procalcitonin, interleukin-6 and interleukin-8, and hyaluronic acid in the Norwegian consensus definition for early-onset neonatal sepsis (EONS)

“… 3 Changes in PCT values in cord and neonatal blood in proven histological chorioamnionitis suggest its production and release by fetal tissue. 4 Another study in neonatal and umbilical cord blood was related to intrauterine infection and useful to predict infection in the newborn infant. 5 In another study of umbilical cord blood samples, both interleukin (IL)-6 and PCT were reliable as a rule-in and a rule-out tool for neonatal sepsis, whereas IL-6 was useful in neonates.…”

Prediction of histological chorioamnionitis and neonatal and infantile outcomes using procalcitonin in the umbilical cord blood and amniotic fluid at birth

“…Sepsis and CAM are among the most devastating causes of neonatal morbidity and mortality, and the prediction and early diagnosis of neonatal sepsis and CAM are very important for neonatal care . To date, several reports have been made on the usefulness of umbilical venous PCT, mainly for two purposes: the prediction of neonatal sepsis and the early diagnosis of CAM .…”