Maternal serum and vaginal fluid C-reactive protein levels do not predict early-onset neonatal infection in preterm premature rupture of membranes

Abstract

Objective: The aim of this study was to evaluate the usefulness of maternal serum and vaginal fluid C-reactive protein (CRP) determinations in the prediction of neonatal congenital infection.Study Design: Fifty women between 24 and 36 weeks gestation, complicated by preterm premature rupture of membranes (pPROM), were divided into two groups according to the presence (n ¼ 14) or absence (n ¼ 36) of early-onset newborns' infection.Result: Maternal serum and vaginal fluid CRP concentrations were comparable between both groups. Serum CRP levels X10 and X15 mg l -1 predicted neonatal infection with a sensitivity of 47 and 47%, specificity of 63 and 76%, positive predictive value (PPV) of 38 and 47%, and negative predictive value (NPV) of 72 and 76%, respectively. The cutoff value of vaginal CRP X2.4 mg l -1 predicted infection with a sensitivity of 71%, specificity of 47%, PPV of 34%, and NPV of 81%. Receiver-operating characteristic curve analysis revealed that the predictive performance of CRP was poor.Conclusion: Maternal serum and vaginal fluid CRP determinations after pPROM are of poor predictive value in neonatal early-onset infection prediction.

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

“…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.…”

Prédiction de l’infection maternofœtale en cas de rupture prématurée des membranes par les marqueurs sériques maternels

“…De trè s nombreuses é tudes ont é valué la valeur pré dictive de la CRP en cas de RPM (Tableau 1) [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34].…”

“…Quatre é tudes ont porté sur la pré diction d'une infection né onatale pré coce chez des femmes ayant une RPM avant terme. Les valeurs pré dictives retrouvé es sont faibles avec, pour des seuils de 10 à 20 mg/l, une sensibilité variant entre 21 % et 56 % et une spé cificité entre 63 % et 95 % et un RV+ entre 1,5 et 4[28,31,33,34].…”

Normal value and changes in CRP values on maternal and fetal umbilical cord blood with the labor and intrapartum interventions

“…The development of neonatal infection and its association with maternal CRP levels has been observed previously 11,13,14 . Research carried out at the University of Philadelphia on the variation of maternal serum and vaginal fluid CRP levels identified that both maternal serum and vaginal fluid CRP determinations after prelabor preterm rupture of the membrane are of poor predictive value in neonatal early-onset infection prediction 11 .…”

“…However, a study conducted in 1990 suggests serum CRP is a useful and rapidly available adjunct to clinical assessment in the diagnosis and exclusion of bacterial infection in the early neonatal period. This has encouraged us to withhold or discontinue antibiotics and has a role in monitoring Research article response to treatment 13 . Another study carried out in India concludes that being a primi mother, prolonged labour, maternal fever, more than three VEs, rupture of the membrane more than 24 hours, foul smelling liquor, urinary tract infection, and cesarean sections significantly associated with elevated CRP levels after 24 hours of the postpartum period.…”