Positive Maternal C-Reactive Protein Predicts Neonatal Sepsis

Abstract

PurposeTo evaluate the diagnostic performance of maternal inflammatory marker: C-reactive protein (CRP) in predicting early onset neonatal sepsis (that occurring within 72 hours after birth).Materials and Methods126 low birth weight newborns (gestation 32±3.2 wk, birth weight 1887±623 g) and their mothers were included. Neonates were divided into sepsis group (n=51) including both proven (positive blood culture) and suspected (negative blood culture but with more than 3 abnormal clinical signs), and controls (n=75). Mothers were subgrouped into CRP positive ≥1.22 mg/dL (n=48) and CRP negative <1.22 mg/dL (n=78) group, determined by Receiver Operating Characteristic curves, and odds ratio was calculated for neonatal sepsis according to maternal condition.ResultsMaternal CRP was significantly higher in neonatal sepsis group than in control (3.55±2.69 vs. 0.48±0.31 mg/dL, p=0.0001). Maternal CRP (cutoff value >1.22 mg/dL) had sensitivity 71% and specificity 84% for predicting neonatal sepsis. Maternal CRP positive group had more neonatal sepsis than CRP negative group (71% vs. 29%, p<0.001). Odds ratio of neonatal sepsis in maternal CRP positive group versus CRP negative group was 10.68 (95% confidence interval: 4.313-26.428, p<0.001).ConclusionThe risk of early onset neonatal sepsis significantly increased in the case of positive maternal CRP (≥1.22 mg/dL). In newborn of CRP positive mother, the clinician may be alerted to earlier evaluation for possible neonatal infection prior to development of sepsis.

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

“…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.…”

Relationship between in utero C-reactive protein levels and asthma in at-risk children

“…19 These elevations in CRP have been found to remain consistently high from the earliest stages of pregnancy through to childbirth. 19e21 However, a higher than usual inflammatory response in pregnant women, as measured by CRP, also has been related to adverse pregnancy outcomes, including preeclampsia, neonatal sepsis, 22 preterm delivery, 23,24 and intrauterine growth restriction. 6,23,25 The present data did not reflect any differences in birth outcomes, as measured by preterm delivery and low birth weight, associated with increased CRP levels in unadjusted analysis.…”

New Biomarkers of Sepsis with Clinical Relevance

“…C-reactive protein (CRP) is an acute inflammatory phase protein produced in the liver, currently believed to be a reliable indicator of inflammation and tissue damage, as it is elevated in cases of infection, inflammatory response, damage, and necrosis of the tissue [16]. Among its actions are platelet activation, chemotaxis acceleration, and enhancement of cell-mediated immunity by promoting phagocytosis [17].…”

“…In 2013, a study conducted at the Department of Pediatrics at Yonsei University of Medicine showed that high levels of CRP in the mother may indicate a risk of infection of the newborn and that these values would be related to the severity of the disease presented by these babies [16].…”