Maternal C-Reactive Protein at Hospital Admission Is a Simple Predictor of Funisitis in Preterm Premature Rupture of Membranes

Perrone, G; Anceschi, Maurizio M.; Capri, Oriana; Gabriela, Paola; Pizzulo, Sabrina; Buccheri, Matteo; Pascone, Roberto; Nofroni, Italo; Brunelli, Roberto

doi:10.1159/000337717

Cited by 19 publications

(23 citation statements)

References 43 publications

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“…It is due to the fact that critical CRP values vary greatly from 5 to 40 mg/l (35). A study by Perrone et al did not prove any significant prognostic value of the WBC count, the same as our study (30). Based on these and other studies, Lee et al suggest that in practice it is worth using the CRP value as an indicator of early-onset neonatal sepsis and a prognostic test of funisitis rather than a diagnostic indicator.…”

Section: Discussionsupporting

confidence: 69%

“…The importance of CRP levels in serum for the diagnosis of funisitis / chorioamnionitis (27)(28)(29)(30), for the determination of neonatal sepsis (31) and the association between neonatal infection and funisitis / chorioamnionitis are discussed in many works of various authors (32)(33). For example, van de Laar made a very important review of scientific works.…”

Section: Discussionmentioning

confidence: 99%

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Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Daunoravičienė¹,

Musteikytė²,

Ramašauskaitė³

2015

AML

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Background. The study investigates the influence of the length of membrane rupture period among pregnant women with preterm premature rupture of membranes (PPROM) between the 32nd and 34th weeks of gestation on the development of chorioamnionitis and the congenital infection of a newborn. It seeks to ascertain the values of indicators in mother's blood that enable to predict chorioamnionitis and funisitis for mothers, and congenital infection for newborns.Materials and methods. A retrospective study of case records of women with PPROM at 32 (32 w. + 0 d)-34 (33 w. + 6 d) weeks of gestation and their newborns was performed. Two comparative groups were made: 1) of women who had funisitis and / or chorioamnionitis with or without deciduitis and 2) of women having no proved inflammation (according to the results of histological examination of placentae). Analogically, comparative groups were made of their newborns: those who had diagnosis of congenital infection and those who had no infection. The duration of membrane rupture period and the blood markers were investigated in all the groups.Results. The study included 135 women. Duration of the membrane rupture period lasted 85.17 ± 84.72 hrs in the group of women who had histological inflammation, and 40.06 ± 56.57 hrs in the group with no inflammation, P = 0.01, AUC = 0.735; the critical membrane rupture period value for developing intrauterine infection by the Youden index was 43.7 hrs. The corresponding maternal CRP values (mg/l) were 25.85 ± 40.27 vs. 5.23 ± 7.88 (P = 0.01, AUC = 0.6), the Youden index 4.6 mg/l. For the mothers of the newborns diagnosed with infection, the duration of the membrane rupture period was 55.95 ± 65.04 hrs, for the mothers of the newborns without congenital infection it was 40.25 ± 73.71 hours. Respectively, CRP values for the mothers of newborns averaged 12.25 ± 22.14 mg/l vs. 4.8 ± 4.82 mg/l (P = 0.005).Conclusions. Longer membrane rupture period and higher maternal CRP are correlated with inflammatory changes in the placenta and umbilical cord, thus they can be used as the prognostic indicators of intrauterine infection. When the duration of the membrane rupture period lasts ≥44 hrs, the risk of chorioamnionitis and funisitis increases five times; when the maternal serum CRP is higher than 5 mg/l, funisitis / chorioamnionitis is twice more frequent than at lower than 5 mg/l CRP values.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Daunoravičienė¹,

Musteikytė²,

Ramašauskaitė³

2015

AML

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“…Elevated maternal plasma concentrations of inflammatory cytokines in preterm gestations complicated by PTL or pPROM are associated with an increased risk of intra-amniotic infection [22, 24, 34, 41, 62, 63, 68, 125, 126, 141, 143, 198]. The findings herein demonstrate that MIAC is associated with decreased maternal plasma concentrations of soluble α-klotho.…”

Section: Commentsmentioning

confidence: 57%

“…The presence of MIAC is associated with increased risk of adverse perinatal outcomes, such as early preterm birth[164, 165, 171, 177, 202, 207], neonatal sepsis[104, 167], bronchopulmonary dysplasia[48, 206], neonatal white matter brain lesions[203, 210], and cerebral palsy[13, 14, 176, 205, 209]. Although MIAC is considered to be confined to the amniotic cavity and not a systemic condition, studies with flow cytometry have shown phenotypic and metabolic changes in leukocytes[45, 46] as well as changes in maternal cytokines concentration [22, 24, 34, 41, 62, 63, 68, 125, 126, 141, 143, 198]. These observations suggest that biomarkers for MIAC may be found in the maternal circulation.…”

Section: Introductionmentioning

confidence: 99%

Infection and smoking are associated with decreased plasma concentration of the anti-aging protein, α-klotho^a

Lam-Rachlin¹,

Romero

Korzeniewski³

et al. 2013

Journal of Perinatal Medicine

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Objective The objective of this study was to determine whether maternal plasma concentrations of soluble α-klotho are different between women with microbial invasion of the intra-amniotic cavity (MIAC) and those without MIAC among preterm labor and intact membranes (PTL) or preterm prelabor rupture of membranes (pPROM). Methods A cross-sectional study was conducted to include women in the following groups:1) PTL with MIAC (n=14); 2) PTL without MIAC (n=79); 3) pPROM with MIAC (n=30); and 4) pPROM without MIAC (n=33). MIAC was defined as a positive amniotic fluid culture for microorganisms (aerobic/anaerobic bacteria or genital mycoplasmas). Amniotic fluid samples were obtained within 48 hours from maternal blood collection. Plasma concentration of soluble α-klotho was determined by ELISA. Results 1) The median plasma concentration (pg/mL) of soluble α-klotho was significantly lower in patients with MIAC than in those without MIAC (787.0 vs. 1117.8; p <0.001); 2) Among patients with PTL, those with MIAC had a lower median plasma concentration (pg/mL) of soluble α-klotho than those without MIAC (787.0 vs. 1138.9; p=0.007); 3) Among patients with pPROM, those with MIAC had a lower median plasma concentration (pg/mL) of soluble α-klotho than those without MIAC (766.4 vs. 1001.6; p=0.045); 4) There was no significant difference in the median plasma concentration of soluble α-klotho between PPROM without MIAC and PTL without MIAC (1001.6 pg/mL vs. 1138.9 pg/mL, respectively; p=0.5); 5) After adjustment for potential confounders (maternal age, tobacco use, gestational age at venipuncture), soluble α-klotho remained significantly associated with MIAC (p= 0.02); and 6) Among patients without MIAC, smoking was significantly associated with a lower median plasma concentration soluble α-klotho than in non-smokers (794.2 pg/mL vs. 1382.0 pg/mL, respectively; p<0.001); however, this difference was not observed in patients with MIAC. Conclusions Intra-amniotic infection occurring at preterm gestations (regardless of membrane status) was associated with a decrease in maternal plasma concentrations of soluble α-klotho. Moreover, among patients without infection, the plasma concentration of soluble α-klotho was lower in smokers.

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“…This breakdown of the DGC could have deleterious effects on plasma membrane stability. In a normal pregnancy, the balance between MMP activation and inhibition is responsible for both minor adjustments necessary to accommodate an enlarging fetus, as well as major changes involved in the initiation of labor and rupture of membranes (ROM) [6,8,9,10]. Increased MMP activity causes degradation of the ECM and separation of the fetal membranes (FM), significantly changing the tensile strength and predisposing to preterm labor or FM rupture.…”

Section: Introductionmentioning

confidence: 99%

Dystroglycan in Human Fetal Membranes Decreases in Later Gestation and with Spontaneous Membrane Rupture

Theiler

Snyder²,

Theiler

2014

Gynecol Obstet Invest

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Background/Aims: The transmembrane protein dystroglycan (DG) is known to anchor the cell membrane to the extracellular matrix, and is susceptible to cleavage by matrix metalloproteinases. This study tested the hypothesis that changes in DG abundance in fetal membranes (FM) occur late in gestation, with spontaneous rupture of membranes (SROM), and during labor. Methods: FM were collected from a prospective cohort consisting of four groups of patients (term labor, term unlabored, preterm labor, and preterm unlabored). FM were subjected to immunohistochemical staining using antibodies specific for α- and β-DG subunits, and staining intensity was graded by a blinded pathologist. Results: α- and β-DG staining was significantly decreased at term and after SROM (p < 0.05), but not in the presence of labor. Conclusions: Decreased DG intensity was seen in FM of patients at term and with SROM, but no change was observed with labor.

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Maternal C-Reactive Protein at Hospital Admission Is a Simple Predictor of Funisitis in Preterm Premature Rupture of Membranes

Cited by 19 publications

References 43 publications

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Infection and smoking are associated with decreased plasma concentration of the anti-aging protein, α-klotho^a

Dystroglycan in Human Fetal Membranes Decreases in Later Gestation and with Spontaneous Membrane Rupture

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Maternal C-Reactive Protein at Hospital Admission Is a Simple Predictor of Funisitis in Preterm Premature Rupture of Membranes

Cited by 19 publications

References 43 publications

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

Infection and smoking are associated with decreased plasma concentration of the anti-aging protein, α-klothoa

Dystroglycan in Human Fetal Membranes Decreases in Later Gestation and with Spontaneous Membrane Rupture

Contact Info

Product

Resources

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Infection and smoking are associated with decreased plasma concentration of the anti-aging protein, α-klotho^a