Background The differentiation of transient tachypnea of the newborn from bacterial pneumonia presents an important diagnostic dilemma in Neonatal Intensive Care Unit.
Aim To evaluate the predictive value of procalcitonin for transient tachypnea of the newborn.
Methods Total 122 babies were included to study. All babies were term. Babies were categorized into three groups: If the baby has prominent grunting after 2. hours of age (Group 1, n=38), if grunting subsided at 2. hours of age and baby has only tachypnea at 24 hours of age (Group 2, n=41), if respiratory distress signs minimal or absent at 24 hours of age (Group 3, n=43). In all groups, procalcitonin levels were determined at birth and 24 hours of age.
Results Procalcitonin levels at birth were significantly higher in Group 1 than other groups, but there was no difference between Groups 2 and 3. Procalcitonin levels at 24 hours of age were significantly higher in Group 1 and 2 than Group 3. No difference was found between Group 1 and Group 2 at 24 hours of age. All procalcitonin values in Group 3 were significantly lower than other groups. PCT tresholds for the diagnosis of transient tachypnea of the newborn were 0.49 ng/ml at birth (sensitivity 59%, specificity 51%); and 5.88ng/ml at 24h of life (sensitivity 80.2%, specificity 90.7%).
Conclusions Serial procalcitonin measurement at birth and 24 hours of age may be helpful in differentiating between pneumonia and transient tachypnea of the newborn. Larger studies are needed to confirm our preliminary results.