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Licensed Unlicensed Requires Authentication Published by De Gruyter February 4, 2022

Perinatal asphyxia partly affects presepsin urine levels in non-infected term infants

Valentina Botondi, Alice Pirra, Mariachiara Strozzi, Marika Perrotta, Danilo A.W. Gavilanes, Laura Di Ricco, Cynzia Spagnuolo, Antonio Maconi, Andrea Rocchetti, Laura Mazzucco, Valeria Balbo, Federico Schena, Giuseppina Stellitano, Arianna Oddi, Andrea Dotta, Iliana Bersani, Andrea Sannia, Chiara Peila, Enrico Bertino, Ines Bianco, Alessandra Gambi, Rocco Mangifesta and Diego Gazzolo



Standard of care sepsis biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT) can be affected by several perinatal factors, among which perinatal asphyxia (PA) has a significant role. In this light, new early sepsis biomarkers such as presepsin (P-SEP) are needed to enact therapeutic strategies at a stage when clinical and laboratory patterns are still silent or unavailable. We aimed at investigating the potential effects of PA on longitudinal P-SEP urine levels.


We conducted an observational case-control study in 76 term infants, 38 with PA and 38 controls. Standard clinical, laboratory, radiological monitoring procedures and P-SEP urine measurement were performed at four time-points (first void, 24, 48, 96 h) after birth.


Higher (p<0.05) CRP and PCT blood levels at T1–T3 were observed in PA than control infants whilst no differences (p>0.05, for all) at T0 were observed between groups. P-SEP urine levels were higher (p<0.05) in PA at first void and at 24 h while no differences (p>0.05) at 48 and 96 h were observed. No significant correlations were found (p>0.05) between P-SEP and urea (R=0.11) and creatinine (R=0.02) blood levels, respectively.


The present results, showed that PA effects on P-SEP were limited up to the first 24 h following birth in absence of any kidney function bias. Data open the way to further investigations aimed at validating P-SEP assessment in non-invasive biological fluids as a reliable tool for early EOS and LOS detection in high-risk infants.

Corresponding author: Prof. Diego Gazzolo, Neonatal Intensive Care Unit, G. d’Annunzio University, 65100 Chieti, Italy, Phone: +39 0871 358219, E-mail:

Funding source: I Colori della Vita Foundation

Award Identifier / Grant number: Grant 2019/3 IO PhD International

Funding source: Mellin, Danone-Nutricia Benefit

Award Identifier / Grant number: Presap ASL-NL-6229


We thank Gepa s.r.l., Italy, for supporting analysis kits.

  1. Research funding: This work is part of the I.O. PhD International Program under the auspices of the Italian Society of Neonatology and was partially supported by grants to DG from “I Colori della Vita Foundation (Grant 2019/3 IO PhD International),” Italy, and by unconditioned sponsorship to DG from Mellin, Danone-Nutricia Benefit (Presap ASL-NL-6229), Italy.

  2. Author contributions: Valentina Botondi, Alice Pirra, Chiara Strozzi, Marika Perrotta, Danilo AW Gavilanes, Laura Di Ricco, Cynzia Spagnuolo, Antonio Maconi, Andrea Rocchetti, Laura Mazzucco, Valeria Balbo, Federico Schena, A Giuseppina Stellitano, Arianna Oddi, Andrea Dotta, Iliana Bersani, Andrea Sannia, Chiara Peila, Enrico Bertino, Ines Bianco, Alessandra Gambi, Rocco Mangifesta and Diego Gazzolo made substantial contribution to conception and design of the study, acquisition, analysis, and interpretation of data; authors participate in drafting the article or revising it critically. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: The parents of the subjects admitted in the study gave informed and signed consent.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013). The local Ethic Committees of the Institutions approved the study protocol (Presap.ASO.Neonat.19.02/ 23.05.19).


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Received: 2021-08-19
Accepted: 2022-01-14
Published Online: 2022-02-04
Published in Print: 2022-04-26

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