Relationship between maternal serum C-reactive protein, funisitis and early-onset neonatal sepsis

• Published in: Journal of Korean medical science Vol. 27; no. 6; pp. 674 - 680
• Main Authors: Lee, Sung Youn, Park, Kyo Hoon, Jeong, Eun Ha, Oh, Kyung Joon, Ryu, Aeli, Park, Kyoung Un
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.06.2012; 대한의학회
• Subjects: Adult; Age of Onset; Area Under Curve; Biomarkers - blood; C-Reactive Protein - analysis; Chorioamnionitis - blood; Chorioamnionitis - diagnosis; Cohort Studies; Female; Fetal Membranes, Premature Rupture - blood; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - blood; Infant, Premature, Diseases - diagnosis; Original; Predictive Value of Tests; Pregnancy; Premature Birth - blood; Retrospective Studies; ROC Curve; Sepsis - blood; Sepsis - diagnosis; 의학일반; Preterm Labor; Preterm Premature Rupture of Membrane; C-Reactive Protein; Funisitis; Early-Onset Neonatal Sepsis
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2012.27.6.674

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.