Prenatal Diagnosis of Intrauterine Infection and Prediction of Neonatal Morbidity by Maternal Serum C-Reactive Protein in Patients with Preterm Premature Rupture of Membranes

Choi, J; Yoon, B H; Shin, H C

Abstract

OBJECTIVE
To investigate the diagnostic and prognostic performance of maternal serum C-reactive protein in patients with preterm premature rupture of membranes (PPROM) as the noninvasive method to detect the intrauterine infection. Study design: At admission, maternal blood was obtained for the determination of C-reactive protein in 120 patients with PPROM.
RESULTS
(1) Patients with acute histologic chorioamnionitis had significantly higher median C-reactive protein concentration (p<0.05).; (2) Patients with clinical chorioamnionitis had significantly higher median C-reactive protein concentration (p<0.0005).; (3) According to receiver operating characteristics (ROC) curve analysis, abnormal maternal C-reactive protein cut-off value was determined as more than 0.7 mg/dl and delivery outcome and neonatal morbidity were compared. Patients with the value of C-reactive protein more than 0.7 mg/dl had frequent premature delivery (p<0.00005), low birth weight (p<0.0001), frequent proven or suspected neonatal sepsis (p<0.05), intraventricular hemorrhage (p<0.05), brochopulmonary dysplasia (p<0.01), and necrotizing enterocolitis (p<0.0005).
CONCLUSION
An elevated maternal serum C-reactive protein concentration identified patients with intrauterine infection and those at risk for adverse perinatal outcome. And the measurement of maternal serum C-reactive protein concentration was a good predictor of intrauterine infection and neonatal morbidity in patients with PPROM.