Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Maternal serum and vaginal fluid C-reactive protein levels do not predict early-onset neonatal infection in preterm premature rupture of membranes

Journal of Perinatology volume 30, pages 655–659 (2010)Cite this article

Subjects

Abstract

Objective:

The aim of this study was to evaluate the usefulness of maternal serum and vaginal fluid C-reactive protein (CRP) determinations in the prediction of neonatal congenital infection.

Study Design:

Fifty women between 24 and 36 weeks gestation, complicated by preterm premature rupture of membranes (pPROM), were divided into two groups according to the presence (n=14) or absence (n=36) of early-onset newborns' infection.

Result:

Maternal serum and vaginal fluid CRP concentrations were comparable between both groups. Serum CRP levels ⩾10 and ⩾15 mg l–1 predicted neonatal infection with a sensitivity of 47 and 47%, specificity of 63 and 76%, positive predictive value (PPV) of 38 and 47%, and negative predictive value (NPV) of 72 and 76%, respectively. The cutoff value of vaginal CRP ⩾2.4 mg l–1 predicted infection with a sensitivity of 71%, specificity of 47%, PPV of 34%, and NPV of 81%. Receiver-operating characteristic curve analysis revealed that the predictive performance of CRP was poor.

Conclusion:

Maternal serum and vaginal fluid CRP determinations after pPROM are of poor predictive value in neonatal early-onset infection prediction.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Fortunato SJ, Menon R, Lombardi SJ . Role of tumor necrosis factor alpha in the premature rupture of membranes and preterm labor pathways. Am J Obstet Gynecol 2002; 187: 1159–1162.

    Article  CAS  Google Scholar 

  2. Kayem G, Goffinet F, Batteux F, Jarreau PH, Weill B, Cabrol D . Detection of interleukin-6 in vaginal secretions of women with preterm premature rupture of membranes and its association with neonatal infection: a rapid immunochromatographic test. Am J Obstet Gynecol 2005; 192: 140–145.

    Article  CAS  Google Scholar 

  3. Shim SS, Romero R, Jun JK, Moon KC, Kim G, Yoon BH . C-reactive protein concentration in vaginal fluid as a marker for intraamniotic inflammation/infection in preterm premature rupture of membranes. J Matern Fetal Neonatal Med 2005; 18: 417–422.

    Article  CAS  Google Scholar 

  4. Mishra UK, Jacobs SE, Doyle LW, Garland SM . Newer approaches to the diagnosis of early onset neonatal sepsis. Arch Dis Child Fetal Neonatal Ed 2006; 91: F208–F212.

    Article  CAS  Google Scholar 

  5. Ghidini A, Salafia CM, Kirn W, Doria V, Spong CY . Biophysical profile in predicting acute ascending infection in preterm rupture of membranes before 32 weeks. Obstet Gynecol 2000; 96: 201–206.

    CAS  PubMed  Google Scholar 

  6. Hatzidaki E, Gourgiotis D, Manoura A, Korakaki E, Bossios A, Galanakis E et al. Interleukin-6 in preterm premature rupture of membranes as an indicator of neonatal outcome. Acta Obstet Gynecol Scand 2005; 84: 632–638.

    Article  Google Scholar 

  7. Levis DF, Barrilleaux PS, Wang Y, Adair CD, Baier J, Kruger T . Detection of interleukin-6 in maternal plasma predicts neonatal and infectious complications in preterm premature rupture of membranes. Am J Perinatol 2001; 18: 387–391.

    Article  Google Scholar 

  8. Martius JA, Roos T, Gora B, Oehler MK, Schrod L, Papadopoulos T et al. Risk factors associated with early-onset sepsis in premature infants. Eur J Obstet Gynecol Reprod Biol 1999; 85: 151–158.

    Article  CAS  Google Scholar 

  9. Park KH, Yoon BH, Shim SS, Jun JK . Amniotic fluid tumor necrosis factor alpha is a marker for the prediction of early-onset neonatal sepsis in preterm labor. Gynecol Obstet Invest 2004; 58: 84–90.

    Article  CAS  Google Scholar 

  10. Di Naro E, Ghezzi F, Raio L . C-reactive protein in vaginal fluid of patients with preterm premature rupture of membranes. Acta Obstet Gynecol Scand 2003; 82: 1072–1079.

    Article  Google Scholar 

  11. Torbé A, Czajka R . Are vaginal fluid procalcitonin levels useful for the prediction of subclinial infection in patients with preterm premature rupture of membranes? J Obstet Gynec Res 2005; 31: 464–470.

    Article  Google Scholar 

  12. Yoon BH, Romero R, Shim JY, Shim SS, Kim CJ, Jun JK . C-reactive protein in umbilical cord blood: a simple and widely available method to assess the risk of amniotic fluid infection and funisitis. J Matern Fetal Neonatal Med 2003; 14: 85–90.

    Article  CAS  Google Scholar 

  13. Chen FC, Sarioglu N, Bûscher U, Dudenhausen JW . Lipopolysaccharide binding protein in the early diagnosis of intraamniotic infection of pregnant women with premature rupture of the membranes. J Perinat Med 2009; 37: 135–139.

    Article  Google Scholar 

  14. He JP . C-reactive protein and acute-phase proteins in monitoring infection caused by premature rupture of membranes. Zhonghua Fu Chan Ke Za Zhi 1990; 25: 98–101.

    CAS  PubMed  Google Scholar 

  15. Kurki T, Teramo K, Ylikorkala O, Paavonen J . C-reactive protein in preterm premature rupture of the membranes. Arch Gynecol Obstet 1990; 217: 31–37.

    Article  Google Scholar 

  16. Saini S, Goel N, Sharma M, Arora B, Garg N . C-reactive proteins as an indicator of sub-clinical infection in cases of premature rupture of membranes. Indian J Phatol Microbiol 2003; 46: 515–516.

    Google Scholar 

  17. krablin S, Lovric H, Banovic V, Kralik S, Dijakovic A, Kalafatic D . Maternal plasma interleukin-6, interleukin-1beta and C-reactive protein as indicators of tocolysis failure and neonatal outcome after preterm delivery. J Matern Fetal Neonatal Med 2007; 20: 335–341.

    Article  Google Scholar 

  18. Yoon BH, Yang SH, Jun JK, Park KH, Kim CJ, Romero R . An elevated C-reactive protein, WBC, or AF WBC identified patients with intrauterine infection and adverse perinatal outcomes. Obstet Gynecol 1996; 87: 231–237.

    Article  CAS  Google Scholar 

  19. Trochez-Martinez RD, Smith P, Lamont RF . Use of C-reactive protein as a predictor of chorioamnionitis in preterm prelabour rupture of membranes: a systematic review. BJOG: Int J Obstet Gynecol 2007; 114: 796–801.

    Article  CAS  Google Scholar 

  20. Wiwanitkit V . Maternal C-reactive protein for the detection of chorioamnionitis: an appraisal. Infect Dis Obstet Gynecol 2005; 13: 179–181.

    Article  CAS  Google Scholar 

  21. Gibbs RS, Romero R, Hillier SL, Eschenbach DA, Sweet RL . A review of premature birth and subclinical infection. Am J Obstet Gynecol 1992; 16: 1515–1528.

    Article  Google Scholar 

  22. Bańkowska E, Leibschang J, Pawlowska A . Usefulness of determination of granulocyte elastase plasma level, C-reactive protein and white blood cell count in prediction of intrauterine infection in pregnant women after PPROM. Ginekol Pol 2003; 74: 1037–1043.

    PubMed  Google Scholar 

  23. Baud O, Emilie D, Pelletier E, Lacaze-Masmonteil T, Zupan V, Fernandez H et al. Amniotic fluid concentrations of interleukin-1beta, interleukin-6 and TNF-alpha in chorioamnionitis before 32 weeks of gestation: histological associations and neonatal outcome. Br J Obstet Gynaecol 1999; 106: 72–77.

    Article  CAS  Google Scholar 

  24. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003; 31: 1250–1256.

    Article  Google Scholar 

  25. Goldstein B, Giroir B, Randolph A . Members of the International Consensus on Pediatric Sepsis. International Pediatric Sepsis Consensus Conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005; 6: 2–8.

    Article  Google Scholar 

  26. Hillier SL, Witkin SS, Krohn MA, Watts DH, Kiviat NB, Eschenbach DA . The relationship of amniotic fluid cytokines and preterm delivery, amniotic fluid infection, histologic chorioamnionitis and chorioamnion infection. Obstet Gynecol 1993; 81: 941–948.

    CAS  PubMed  Google Scholar 

  27. Torbé A . Evaluation of cytokines and procalcitonin concentrations in cervico-vaginal secretion, in plasma blood and in amniotic fluid in pregnancy complicated by preterm labor. Habilitation thesis. Ann Acad Med Stetin 2003; Supl 92.

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland

    A Torbé & K Kowalski

Authors
  1. A Torbé
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K Kowalski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A Torbé.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Torbé, A., Kowalski, K. Maternal serum and vaginal fluid C-reactive protein levels do not predict early-onset neonatal infection in preterm premature rupture of membranes. J Perinatol 30, 655–659 (2010). https://doi.org/10.1038/jp.2010.22

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2010.22

Keywords

Search

Advanced search

Quick links