Is It Useful to Measure C-Reactive Protein and Leukocytes in Patients with Prelabor Rupture of Membranes?

Heyden, Jantien L. van der; Teeffelen, Stijn S.P van; Coolen, Anne C.G; Halbertsma, F.J.; Aardenburg, Robert; Mertens, H; Mol, Ben Willem J.

doi:10.1055/s-0030-1248941

Cited by 20 publications

(18 citation statements)

References 6 publications

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“…Nevertheless, in the current study the AUC for the maternal serum CRP was relatively small (95% CI, 0.600-0.800) and the likelihood ratio was 1.84, which suggests that the usefulness of serum CRP alone as a predictor of early-onset neonatal sepsis is limited. These findings are in agreement with the recent study by van der Heyden et al (24). …”

Section: Discussionsupporting

confidence: 94%

“…A number of studies have assessed the relationship between early-onset neonatal sepsis and the maternal serum CRP level; some studies have demonstrated a significant association (12, 23, 24), while other studies have failed to do so (25, 26). This discrepancy among studies is probably attributable, in part, to a wide variety of time intervals between CRP measurement and delivery.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between Maternal Serum C-Reactive Protein, Funisitis and Early-Onset Neonatal Sepsis

et al. 2012

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The aim of this study was to determine whether maternal serum C-reactive protein (CRP) is of value in predicting funisitis and early-onset neonatal sepsis (EONS) in women with preterm labor or preterm premature rupture of membranes (PROM). This retrospective cohort study included 306 consecutive women with preterm labor or preterm PROM who delivered preterm singleton neonates (23-35 weeks gestation) within 72 hr of CRP measurement. The CRP level was measured with a highly sensitive immunoassay. The sensitivity, specificity, positive predictive value, and negative predictive value of an elevated serum CRP level (≥ 8 mg/L) were 74.1%, 67.5%, 32.8%, and 92.4% for funisitis, and 67.7%, 63.3%, 17.2%, and 94.6% for EONS, respectively. Logistic regression analysis demonstrated that elevated levels of serum CRP were significantly associated with funisitis and EONS, even after adjusting gestational age. The maternal serum CRP level obtained up to 72 hr before delivery is an independent predictor of funisitis and EONS in women with preterm labor or preterm PROM. A low serum CRP level (< 8 mg/L) has good negative predictive value in excluding funisitis and EONS, and may therefore be used as a non-invasive adjunct to clinical judgment to identify low-risk patients.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Relationship between Maternal Serum C-Reactive Protein, Funisitis and Early-Onset Neonatal Sepsis

et al. 2012

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“…A simple and more repeatable method would be assessment of maternal serum inflammation markers: however there is still no consensus on the ideal marker as far as sensitivity and specificity is concerned [12,13,14,15,16,17]. …”

Section: Introductionmentioning

confidence: 99%

“…The usefulness of maternal CRP as a marker of fetal intrauterine infection in pPROM has been investigated by numerous authors, but results are still controversial [10,11,12,13,14,15] due to bias linked to different methodologies and study models.…”

Section: Introductionmentioning

confidence: 99%

Maternal C-Reactive Protein at Hospital Admission Is a Simple Predictor of Funisitis in Preterm Premature Rupture of Membranes

Perrone¹,

Anceschi²,

Capri³

et al. 2012

Gynecol Obstet Invest

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Aim: To analyze the prognostic value of maternal serum C-reactive protein (CRP) in predicting funisitis in patients with preterm premature rupture of membranes (pPROM). Methods: 66 patients (gestational age 24–33 weeks) hospitalized 1–12 h after pPROM were enrolled. White blood cell count (WBC), platelet count (PLT) and plasma concentration of CRP were assessed every 3 days. Histological evidence of chorioamnionitis and funisitis was obtained post-partum. Receiver operating characteristic (ROC) curves were employed to evaluate the role of maternal CRP in predicting funisitis. Results: Funisitis was found in 24 patients (36.3%); 42 patients (63.7%) without funisitis were considered as controls. PLT and WBC at admission and before delivery did not show significant differences and were not statistically different between the two groups. Patients with funisitis had significantly higher CRP levels both at admission to hospital and 24– 48 h before delivery. ROC curve analysis showed that CRP at admission (area under the curve: 0.671, p = 0.021) and before delivery (area under the curve: 0.737, p = 0.001) are predictive of funisitis. Conclusions: High maternal serum CRP levels (>20,000 µg/l) in pPROM patients at admission to hospital may be an early marker which indicates, with a good diagnostic performance, the presence of funisitis.

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“…Of them, maternal CRP has been reported to be valuable for early detection of neonatal sepsis 13,14. Conflicting results on use of maternal CRP in prediction of neonatal sepsis have been reported 15,16…”

Section: Introductionmentioning

confidence: 99%

Positive Maternal C-Reactive Protein Predicts Neonatal Sepsis

et al. 2014

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PurposeTo evaluate the diagnostic performance of maternal inflammatory marker: C-reactive protein (CRP) in predicting early onset neonatal sepsis (that occurring within 72 hours after birth).Materials and Methods126 low birth weight newborns (gestation 32±3.2 wk, birth weight 1887±623 g) and their mothers were included. Neonates were divided into sepsis group (n=51) including both proven (positive blood culture) and suspected (negative blood culture but with more than 3 abnormal clinical signs), and controls (n=75). Mothers were subgrouped into CRP positive ≥1.22 mg/dL (n=48) and CRP negative <1.22 mg/dL (n=78) group, determined by Receiver Operating Characteristic curves, and odds ratio was calculated for neonatal sepsis according to maternal condition.ResultsMaternal CRP was significantly higher in neonatal sepsis group than in control (3.55±2.69 vs. 0.48±0.31 mg/dL, p=0.0001). Maternal CRP (cutoff value >1.22 mg/dL) had sensitivity 71% and specificity 84% for predicting neonatal sepsis. Maternal CRP positive group had more neonatal sepsis than CRP negative group (71% vs. 29%, p<0.001). Odds ratio of neonatal sepsis in maternal CRP positive group versus CRP negative group was 10.68 (95% confidence interval: 4.313-26.428, p<0.001).ConclusionThe risk of early onset neonatal sepsis significantly increased in the case of positive maternal CRP (≥1.22 mg/dL). In newborn of CRP positive mother, the clinician may be alerted to earlier evaluation for possible neonatal infection prior to development of sepsis.

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Is It Useful to Measure C-Reactive Protein and Leukocytes in Patients with Prelabor Rupture of Membranes?

Cited by 20 publications

References 6 publications

Relationship between Maternal Serum C-Reactive Protein, Funisitis and Early-Onset Neonatal Sepsis

Relationship between Maternal Serum C-Reactive Protein, Funisitis and Early-Onset Neonatal Sepsis

Maternal C-Reactive Protein at Hospital Admission Is a Simple Predictor of Funisitis in Preterm Premature Rupture of Membranes

Positive Maternal C-Reactive Protein Predicts Neonatal Sepsis

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