Procalcitonin and C-Reactive Protein in Umbilical Cord Blood as Markers for Early Suspicion of Infection in Newborns of Women with Prenatal Urinary Tract Infection

Abstract

Introduction/Background Maternal urinary tract infection, in the antenatal period, has been implicated as a risk factor for the occurrence of intraamniotic infection, hypertension, maternal anemia, premature labor, and low birth weight, highlighting the importance of urine examination antepartum. Was observed that acute urinary tract infection during pregnancy was associated with fetal mortality in 17.9{%} of live births, and that early-onset neonatal sepsis was of major concern. We aimed to investigate whether concentrations of procalcitonin (PCT) and C-reactive protein (CRP) in the umbilical cord blood are valid biomarkers for detection of infection in newborns of pregnant women with urinary tract infections. Patients and Methods From January to December 2011, in a public maternity hospital in Niteroi,-Rio de Janeiro, Brazil, was carried out through a prospective study of newborns whose mothers were diagnosed with untreated or inadequately treated urinary tract infections, during the final trimester of pregnancy, PCT and CRP were measured both singly and combined, in parallel and in series and the sensitivity, specificity and negative and positive predictive values were verified. Results We analyzed blood from 93 newborns at full term, with appropriate birth weights, no asphyxia or signs of bacterial infection. Of these, 42 mothers had urinary tract infections during the third trimester. The sensitivity, specificity, positive predictive value and negative predictive value of PCT were 44{%}, 51{%}, 15{%} and 82{%} and of CRP were 2{%}, 92{%}, 20{%} and 50{%}, respectively. In parallel, the results were 45{%}, 47{%}, 42{%} and 89{%} and in series 8{%}, 96{%}, 18{%} and 90{%}, respectively. Conclusion The combination of PCT and CRP in series elevated the specificity, indicating that it may be useful in ruling out suspicion of early infection in newborns of pregnant women with urinary tract infections during the final trimester of pregnancy.