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

AIM: We aimed to clarify the usefulness of procalcitonin (PCT) in the evaluation of histological chorioamnionitis (CAM) and in the prediction of neonatal and infantile outcomes as a reference of interleukin‐6 (IL‐6). METHODS: Subjects were 36 singleton pregnant women delivered at 22–37 weeks’ gestation due to threatened premature delivery and/or preterm premature rupture of membranes. Cases were classified into the CAM and non‐CAM groups, according to Blanc's criteria. Comparisons were made on umbilical venous and amniotic fluid PCT levels among the groups. The relations between umbilical venous PCT and IL‐6 levels and neonatal and infantile outcomes were also analyzed. RESULTS: The umbilical venous PCT level in the CAM group (240.2 pg/mL, 125.4–350.3 pg/mL: median, first quartile–third quartile) was higher than that in the non‐CAM group (105.1, 50.2–137.5 pg/mL; P = 0.0006). There were no differences in the amniotic fluid PCT levels between the groups. There was a strong correlation between umbilical venous PCT and IL‐6 levels (correlation coefficient: 0.793). Among 10 cases with an umbilical venous PCT level of ≥170.0 pg/mL and six cases with IL‐6 ≥ 11.0 pg/mL, six (60.0%) and five cases (83.3%), respectively, had adverse neonatal and infantile outcomes. Among seven cases with adverse neonatal and infantile outcomes, six (85.7%) and five (71.4%) cases showed umbilical venous PCT levels of ≥170.0 pg/mL and IL‐6 levels of ≥11.0 pg/mL, respectively. CONCLUSION: Similar to IL‐6, the umbilical venous PCT level is a promising parameter for predicting histological CAM and adverse neonatal and infantile outcomes related to in utero inflammatory status.