Applying Maternal Serum and Amniotic Fluid CRP Concentrations, and Cervical Length to Predict Preterm Delivery

To investigate the clinical advantage of several prognostic factors for predicting preterm delivery.

Eighty and six patients with a singleton pregnancy admitted to Vali-Asr hospital underwent genetic amniocentesis between the 15th and 23th weeks were included in this study. Maternal serum C-reactive protein (CRP), transvaginal sonographic measurement of cervical length (CL),were examined on genetic amniocentesis time. Receiver-operating characteristic (ROC) analysis was performed to determine the efficacy of maternal serum and amniotic fluid CRP levels in predicting women with preterm delivery. Correlation between each factor and the duration of pregnancy was investigated.

The prevalence of spontaneous preterm delivery before 37 weeks of gestation was 11%. ROC analysis revealed that maternal serum CRP level was the parameter, which had a significant power in the prediction of preterm delivery. The optimum cut-off level was 1.2 mg/L. The sensitivity and specificity were 95.1% and 91.8%, respectively. The positive predictive value for CL length with the cut off value of 25 mm was 72.1%. No statistically significant difference correlation observed between CL and the duration of pregnancy or amniotic fluid and maternal serum CRP levels.

The maternal serum CRP level has a good sensitivity and specificity in the prediction of preterm delivery and this may be helpful in predicting preterm delivery during genetic amniocentesis. Maternal serum CRP measurement is a safe, simple clinically useful, cost effective, non invasive method, that may assist clinicians in evaluation for high-risk patients and determine strategies for the prevention of preterm delivery.