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

Lee, Sung Youn; Park, Kyo Hoon; Jeong, Eun-Hee; Oh, Kyung Joon; Ryu, Aeli; Park, Kyoung Un

doi:10.3346/jkms.2012.27.6.674

Cited by 44 publications

(37 citation statements)

References 29 publications

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“…Regarding infant's data, our results confirm findings of previous studies so far reporting high incidence of morbidity in terms of shortening of gestational age [3]- [6], [8]- [10], [18], prematurity and restriction of birth weight [3]- [10] due to effect of stress mediators on myometrial irritability and materno-fetal inflammatory climate [20]. Based on our results, perinatal death should be for the first time added to the list.…”

Section: Discussionsupporting

confidence: 80%

Maternal Stress and Pregnancy Outcomes

Tandu-Umba¹,

Dedetemo²,

Mananga³

2014

OJOG

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Aims of the study: To seek for magnitude of stress conditions among pregnant women, the clinical profile of stressed pregnant women and the potential of stress on adverse maternal and perinatal outcomes in Kinshasa. Methods: This is a multicentre 6-month case-control study dealing with consenting women having given birth at 13 biggest maternities of Kinshasa, the capital of DR Congo. Mother-infant pairs were considered cases (obviously stressed women) and controls (light or not stressed women) at the end of data processing according to their perceived stress scores (PSS). Stress events, potential stress factors and maternal general and physical characteristics were registered along with maternal and perinatal outcomes. Odds ratios calculation allowed finding influence of stress on occurrence of adverse outcomes. Results and conclusions: Our study concerned 1082 women whose 57.1% (n = 618) qualified as the stressed. General characteristics found significantly different between stressed and non-stressed women were marital status (the married and widowed more frequent among the stressed), instruction level (the educated more frequent among the stressed), socioeconomic status (the elevated more frequent among the stressed) and religion status (both the traditional and new charismatic more frequent among the stressed). Obstetric risk factors were similar in both groups that were different only according to stress factors, whether emotional (relationships) or pregnancy (preciousness) related. The 3 most prominent stress factors were parent's death (p 0.000), tension in family (p 0.000) and tension in couple (p 0.003). All expectedly compensating factors appeared significantly more frequent among stressed women. As of organic pregnancy outcomes infection, gastritis, hypertensive disorders and preterm labor were maternal ones significantly more frequent among stressed women. All non-organic outcomes (insomnia and depression) were significantly predominant among stressed women. In offspring, prematurity, low birth weight and perinatal death were significantly dominant among those born to stressed women. Odds ratios calculation showed significant potential of stress conditions on occurrence of all maternal complications but cesarean section. In * This study was approved by the scientific board of the faculty of medicine (University of Kinshasa). # Corresponding author.B. Tandu-Umba et al. 362offspring too, risk of outcomes' occurrence was enhanced by stress, except for macrosomia and neonatal distress.

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Section: Discussionsupporting

confidence: 80%

Maternal Stress and Pregnancy Outcomes

Tandu-Umba¹,

Dedetemo²,

Mananga³

2014

OJOG

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“…The importance of CRP levels in serum for the diagnosis of funisitis / chorioamnionitis (27)(28)(29)(30), for the determination of neonatal sepsis (31) and the association between neonatal infection and funisitis / chorioamnionitis are discussed in many works of various authors (32)(33). For example, van de Laar made a very important review of scientific works.…”

Section: Discussionmentioning

confidence: 99%

“…Based on these and other studies, Lee et al suggest that in practice it is worth using the CRP value as an indicator of early-onset neonatal sepsis and a prognostic test of funisitis rather than a diagnostic indicator. It can help to classify women into two groups of those who run high risk (have high CRP levels) and those who are in low risk (have low CRP levels) (32).…”

Section: Discussionmentioning

confidence: 99%

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Daunoravičienė¹,

Musteikytė²,

Ramašauskaitė³

2015

AML

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Background. The study investigates the influence of the length of membrane rupture period among pregnant women with preterm premature rupture of membranes (PPROM) between the 32nd and 34th weeks of gestation on the development of chorioamnionitis and the congenital infection of a newborn. It seeks to ascertain the values of indicators in mother's blood that enable to predict chorioamnionitis and funisitis for mothers, and congenital infection for newborns.Materials and methods. A retrospective study of case records of women with PPROM at 32 (32 w. + 0 d)-34 (33 w. + 6 d) weeks of gestation and their newborns was performed. Two comparative groups were made: 1) of women who had funisitis and / or chorioamnionitis with or without deciduitis and 2) of women having no proved inflammation (according to the results of histological examination of placentae). Analogically, comparative groups were made of their newborns: those who had diagnosis of congenital infection and those who had no infection. The duration of membrane rupture period and the blood markers were investigated in all the groups.Results. The study included 135 women. Duration of the membrane rupture period lasted 85.17 ± 84.72 hrs in the group of women who had histological inflammation, and 40.06 ± 56.57 hrs in the group with no inflammation, P = 0.01, AUC = 0.735; the critical membrane rupture period value for developing intrauterine infection by the Youden index was 43.7 hrs. The corresponding maternal CRP values (mg/l) were 25.85 ± 40.27 vs. 5.23 ± 7.88 (P = 0.01, AUC = 0.6), the Youden index 4.6 mg/l. For the mothers of the newborns diagnosed with infection, the duration of the membrane rupture period was 55.95 ± 65.04 hrs, for the mothers of the newborns without congenital infection it was 40.25 ± 73.71 hours. Respectively, CRP values for the mothers of newborns averaged 12.25 ± 22.14 mg/l vs. 4.8 ± 4.82 mg/l (P = 0.005).Conclusions. Longer membrane rupture period and higher maternal CRP are correlated with inflammatory changes in the placenta and umbilical cord, thus they can be used as the prognostic indicators of intrauterine infection. When the duration of the membrane rupture period lasts ≥44 hrs, the risk of chorioamnionitis and funisitis increases five times; when the maternal serum CRP is higher than 5 mg/l, funisitis / chorioamnionitis is twice more frequent than at lower than 5 mg/l CRP values.

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“…These activated leukocytes release stress mediators that are basis for pluri-visceral damages, alteration of sub-decidual angiogenesis, reduction in intrauterine blood flow and mother-fetus transfer of stress substances, resulting in myometrial irritability and fetal inflammatory climate [25]. These effects are accountable for in reportedly high frequencies of pregnancy loss [26], shortening of gestational age, prematurity, restriction of birth weight [27]- [33] and neonatal intravascular hemorrhage [34] in increase of maternal blood pressure, which is likely to lead not only to preeclampsia-eclampsia (PE) but also to intrauterine growth restriction (IUGR) and premature labor [41].…”

Section: A M Mbangama Et Al Open Journal Of Obstetrics and Gynecologymentioning

confidence: 99%

Rationale of a Cohort Study on Risk of Obstetrical Outcomes Associated with Iron Supplementation during Pregnancy

Mbangama¹,

Tandu-Umba²,

Mbungu³

2018

OJOG

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Background: Anemia is one of the most widely prevalent disorders, affecting the lives of almost half a billion women of reproductive age, contributing to over 100,000 maternal and almost 600,000 perinatal deaths (mostly through pre-term delivery, low birth weight) each year. Increased risk of infant mortality and reduced cognitive development and reduced energy levels which affect productivity in adults are cited. During pregnancy increased requirements, inadequate intake of iron and other micronutrients and parasitic (malaria, hookworm) as wells as bacterial (mostly urinary tract) infections are the main causes. In order to reduce such maternal and neonatal burden, it has been worldwide admitted to adopt cost-effective preventive interventions during pregnancy, including iron-folic acid supplementation, de-hookworming medication and anti-malarial prevention or treatment. Intestinal absorption of iron is limited by a lot of factors including bioavailability, iron status of the woman, substances accompanying or contained in diet, chelating agents such as diet fibers or calcium salts. Any supplementation put additional constraint in terms of absorption. Unabsorbed iron is known to have pro-oxidant properties likely to induce production of free radicals. These in turn might induce oxidative stress accountable for in generation of many obstetrical outcomes. This potential link between oxidative stress resulting from free radicals hyperproduction induced by non absorbed iron and harmful maternal/perinatal conditions is rarely questioned by searchers. Objectives: To determine overall (food and supplemented) iron consumption, iron and oxidative status in a cohort of pregnant women and to seek associations between findings and adverse obstetrical outcomes. Methods: At the University Clinics of Kinshasa, we designed a protocol for a prospective cohort study dealing with clinical and biochemical parameters of oxidative stress among pregnant women iron supplemented. Women with a single pregnancy not exceeding 19 weeks without obvious pathology, regardless of age and parity, were eligible for inclusion in the study. Conclusion: This study is expected to assess consequences of oral iron supplementation during pregnancy in terms of obstetrical outcomes associated with oxidative stress linked to unabsorbed iron.

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

Cited by 44 publications

References 29 publications

Maternal Stress and Pregnancy Outcomes

Maternal Stress and Pregnancy Outcomes

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Rationale of a Cohort Study on Risk of Obstetrical Outcomes Associated with Iron Supplementation during Pregnancy

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