C-reactive protein as a predictor of chorioamnionitis

Area of Science:

• Perinatal Medicine
• Maternal-Fetal Medicine
• Infectious Disease in Pregnancy

Background:

• Chorioamnionitis (CAM) is a common complication in pregnancies with preterm premature rupture of membranes (PPROM).
• Accurate prediction of CAM is crucial for timely management and improved neonatal outcomes.
• Identifying reliable serum biomarkers for early CAM detection remains a clinical challenge.

Purpose of the Study:

• To evaluate C-reactive protein (CRP) as an early predictive marker for CAM in patients diagnosed with PPROM.
• To assess the efficacy of CRP in identifying both clinical and histologic CAM.
• To determine if sequential CRP measurements improve CAM prediction.

Main Methods:

• Retrospective analysis of 73 pregnant women with PPROM.
• Comparison of CRP levels, latency, white blood cell count, and other factors between groups with and without histologic CAM.
• Logistic regression and receiver operating characteristic (ROC) curve analysis to assess predictive value.
• Secondary analysis to evaluate the association of CRP change with clinical CAM development.

Main Results:

• No significant difference in baseline CRP levels between women with and without histologic CAM.
• Histologic CAM group delivered at earlier gestational ages (29.5 vs 31.9 weeks).
• ROC analysis of CRP, temperature, and WBC yielded an area under the curve of 0.696, indicating moderate predictive ability.
• Adjusted analysis showed a statistically significant association between increasing CRP levels and clinical CAM development over time (HR 1.05).

Conclusions:

• C-reactive protein (CRP) is not an effective independent predictor of clinical or histologic chorioamnionitis (CAM) in patients with preterm premature rupture of membranes (PPROM).
• Sequential CRP testing did not prove statistically significant for identifying CAM in this cohort.
• While baseline CRP is not predictive, changes in CRP may be associated with clinical CAM development over time.