Objective:To determine normal concentrations of procalcitonin in preterm infants shortly after birth and to assess its accuracy in detecting bacterial infection. Methods:Blood samples of 100 preterm infants were prospectively drawn during the first 4 days of life for determination of procalcitonin concentration. Infants were classified into four groups according to their sepsis status.Results:Mean (SD) gestational age and birth weight were 32(2.9) weeks and 1682 (500) g respectively. A total of 283 procalcitonin concentrations from healthy infants were plotted to construct nomograms of physiologically raised procalcitonin concentration after birth,stratified by two groups to 24-30 and 31-36 weeks gestation. The peak 95th centile procalcitonin concentration was plotted at 28 hours of age; values return to normal after 4 days of life. Only 12 infants were infected,and 13 of their 16 procalcitonin concentrations after birth were higher than the 95th centile,whereas samples taken at birth were lower.In a multivariable analysis,gestational age,premature rupture of membrane,and sepsis status influenced procalcitonin concentration independently,but maternal infection status did not.Conclusions:The suggested neonatal nomograms of preterm infants are different from those of term infants. Procalcitonin concentrations exceeding the 95th centile may be helpful in detecting congenital infection,but not at birth.
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