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Age-specific percentile-based reference curve of serum procalcitonin concentrations in Japanese preterm infants
Noriko Fukuzumi1, Kayo Osawa2,3, Itsuko Sato1
1Department of Clinical Laboratory, Kobe University Hospital, Kobe, 6500017, Japan.
Insights
Serum procalcitonin (PCT) levels differ significantly in preterm infants compared to term infants. Establishing age-specific reference curves for PCT is crucial for detecting infections in preterm neonates.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatrics
Background:
- Procalcitonin (PCT) levels rise early in newborns but reference ranges in preterm infants are not well-defined.
- Understanding PCT physiology is key for diagnosing infections in vulnerable neonates.
Purpose of the Study:
- To establish age-specific percentile-based reference curves for serum PCT concentrations in preterm infants.
- To characterize the physiological features of serum PCT in this population.
Main Methods:
- Serum samples were collected from preterm infants.
- PCT concentrations were measured and analyzed to create percentile-based reference curves.
- Comparisons were made between different gestational age groups and with term infants.
Main Results:
- PCT levels peaked at 1 day old and decreased subsequently.
- Preterm infants (<34 weeks GA) had higher PCT levels at 1 day old than late preterm and term infants.
- Preterm infants required 9 weeks to reach adult normal PCT levels, unlike late preterm/term infants who reached it by 5 days.
- Infected preterm infants showed PCT levels above the 95th percentile.
Conclusions:
- Physiological PCT patterns in preterm infants differ significantly from late preterm and term infants.
- Age-specific PCT reference curves are valuable tools for detecting late-onset bacterial infections and sepsis in preterm neonates.
Abstract:
Procalcitonin (PCT) levels are elevated early after birth in newborn infants; however, the physiological features and reference of serum PCT concentrations have not been fully studied in preterm infants. The aims of the current study were to establish an age-specific percentile-based reference curve of serum PCT concentrations in preterm infants and determine the features. The PCT concentration peaked in infants at 1 day old and decreased thereafter. At 1 day old, serum PCT concentrations in preterm infants <34 weeks' gestational age were higher than those in late preterm infants between 34 and 36 weeks' gestational age or term infants ≥37 weeks' gestational age. Although the 50-percentile value in late preterm and term infants reached the adult normal level (0.1 ng/mL) at 5 days old, it did not in preterm infants. It took 9 weeks for preterm infants to reach it. Serum PCT concentrations at onset in late-onset infected preterm infants were over the 95-percentile value. We showed that the physiological feature in preterm infants was significantly different from that in late preterm infants, even in those <37 weeks' gestational age. To detect late-onset bacterial infection and sepsis, an age-specific percentile-based reference curve may be useful in preterm infants.
