Value of Procalcitonin in Neonatal Infection within 24 Hours after Birth: a Retrospective Cohort Study

Background: Neonatal infections, especially neonatal pneumonia, are clinically common and have a high mortality rate. Early diagnosis and the duration of appropriate antibiotic treatment are critical. PCT is an indication of infection and may be valuable. Methods: This is a retrospective cohort of 269 neonates within 24 hours after birth, analyzing the value of procalcitonin, C-reactive protein, and white blood cell count in neonatal infections, especially neonatal pneumonia, and antibiotic therapy. Results: The median of PCT, CRP, and WBC in the severely infected group, neonatal pneumonia group, neonatal infection group, and non-infectious disease group were (1.76, 5.25, 15.8), (0.20, 0.53, 13.8), (0.22, 3.64, 10.4), and (0.15, 0.39, 10.6), respectively. In ROC curves, PCT had an area under the curve (AUC) of 0.64 (95% CI, 0.49 - 0.0.79); CRP had an AUC of 0.61 (95% CI, 0.49 - 0.74); WBC had an AUC of 0.78 (95% CI, 0.67 - 0.88). There was a significant difference between the neonatal pneumonia with PCT results group and the neonatal pneumonia without PCT results group, p < 0.001. The median of antibiotic treatment was 4.0 d (95% CI 3.7 - 4.8) in the neonatal pneumonia with PCT results group vs. 4.9 d (95% CI 4.5 - 5.6) in the standard group; p < 0.001. Conclusions: PCT helps identify neonate infections and grades of infections and assists pediatricians in deciding when to stop antibiotic treatment; PCT and WBC help improve the accuracy of neonatal pneumonia diagnosis.