Intra-Amniotic Infection Prediction Score Based on Simple Maternal Information for Preterm Premature Rupture of...

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Infectious Diseases in Pregnancy

Background:

• Preterm premature rupture of membranes (PPROM) is a significant risk factor for intra-amniotic infection (IAI).
• IAI can lead to severe maternal and neonatal complications, including sepsis and preterm birth.
• Accurate and timely prediction of IAI in PPROM is crucial for appropriate clinical management.

Purpose of the Study:

• To develop and validate a predictive model for intra-amniotic infection (IAI) in patients with PPROM.
• To utilize simple maternal clinical parameters for the predictive model.
• To assess the diagnostic accuracy of the developed scoring system.

Main Methods:

• Retrospective cohort study of pregnant women with PPROM (22 0/7 to 35 6/7 weeks gestation).
• Patients divided into development (2013-2017) and validation (2018-2023) cohorts.
• IAI defined as microbial invasion of amniotic cavity with inflammation; predictive model based on gestational age, WBC count, and CRP levels.

Main Results:

• A scoring system was developed using gestational age (<32 weeks), white blood cell (WBC) count (≥11,400/μL), and C-reactive protein (CRP) level (≥0.51 mg/dL).
• High diagnostic accuracy observed with areas under the receiver operating characteristic curve of 0.92 (development) and 0.86 (validation).
• Predicted probabilities correlated well with observed probabilities across different scores, demonstrating model reliability.

Conclusions:

• A validated predictive score using WBC count, CRP level, and gestational age accurately identifies IAI risk in PPROM.
• The developed model shows high diagnostic performance in both development and validation cohorts.
• Further validation in diverse populations is recommended for broader clinical application of this predictive tool.