Limits...
Relationship between maternal serum C-reactive protein, funisitis and early-onset neonatal sepsis.

Lee SY, Park KH, Jeong EH, Oh KJ, Ryu A, Park KU - J. Korean Med. Sci. (2012)

Bottom Line: The sensitivity, specificity, positive predictive value, and negative predictive value of an elevated serum CRP level (≥ 8 mg/L) were 74.1%, 67.5%, 32.8%, and 92.4% for funisitis, and 67.7%, 63.3%, 17.2%, and 94.6% for EONS, respectively.Logistic regression analysis demonstrated that elevated levels of serum CRP were significantly associated with funisitis and EONS, even after adjusting gestational age.A low serum CRP level (< 8 mg/L) has good negative predictive value in excluding funisitis and EONS, and may therefore be used as a non-invasive adjunct to clinical judgment to identify low-risk patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
The aim of this study was to determine whether maternal serum C-reactive protein (CRP) is of value in predicting funisitis and early-onset neonatal sepsis (EONS) in women with preterm labor or preterm premature rupture of membranes (PROM). This retrospective cohort study included 306 consecutive women with preterm labor or preterm PROM who delivered preterm singleton neonates (23-35 weeks gestation) within 72 hr of CRP measurement. The CRP level was measured with a highly sensitive immunoassay. The sensitivity, specificity, positive predictive value, and negative predictive value of an elevated serum CRP level (≥ 8 mg/L) were 74.1%, 67.5%, 32.8%, and 92.4% for funisitis, and 67.7%, 63.3%, 17.2%, and 94.6% for EONS, respectively. Logistic regression analysis demonstrated that elevated levels of serum CRP were significantly associated with funisitis and EONS, even after adjusting gestational age. The maternal serum CRP level obtained up to 72 hr before delivery is an independent predictor of funisitis and EONS in women with preterm labor or preterm PROM. A low serum CRP level (< 8 mg/L) has good negative predictive value in excluding funisitis and EONS, and may therefore be used as a non-invasive adjunct to clinical judgment to identify low-risk patients.

Show MeSH

Related in: MedlinePlus

Receiver operating characteristic (ROC) curves for maternal serum C-reactive protein (CRP). (A) For predicting funisitis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.751; SE, 0.036; P < 0.001). (B) For predicting early-onset neonatal sepsis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.700; SE, 0.051; P < 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3369455&req=5

Figure 1: Receiver operating characteristic (ROC) curves for maternal serum C-reactive protein (CRP). (A) For predicting funisitis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.751; SE, 0.036; P < 0.001). (B) For predicting early-onset neonatal sepsis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.700; SE, 0.051; P < 0.001).

Mentions: Fig. 1A is a ROC curve describing the values of the serum CRP levels in predicting funisitis. The curve constructed for the maternal serum CRP was above the 45° line, indicating a significant relationship with funisitis (area under the curve [AUC], 0.751; standard error [SE], 0.036; P < 0.001). The best cut-off value for CRP to predict funisitis was 8 mg/L. The sensitivity, specificity, PPV, NPV, LR+, and LR- of an elevated serum CRP level (≥ 8 mg/L) to predict funisitis are shown in Table 2.


Relationship between maternal serum C-reactive protein, funisitis and early-onset neonatal sepsis.

Lee SY, Park KH, Jeong EH, Oh KJ, Ryu A, Park KU - J. Korean Med. Sci. (2012)

Receiver operating characteristic (ROC) curves for maternal serum C-reactive protein (CRP). (A) For predicting funisitis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.751; SE, 0.036; P < 0.001). (B) For predicting early-onset neonatal sepsis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.700; SE, 0.051; P < 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369455&req=5

Figure 1: Receiver operating characteristic (ROC) curves for maternal serum C-reactive protein (CRP). (A) For predicting funisitis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.751; SE, 0.036; P < 0.001). (B) For predicting early-onset neonatal sepsis. Numbers next to solid dots represent serum CRP levels (mg/L; area under the curve, 0.700; SE, 0.051; P < 0.001).
Mentions: Fig. 1A is a ROC curve describing the values of the serum CRP levels in predicting funisitis. The curve constructed for the maternal serum CRP was above the 45° line, indicating a significant relationship with funisitis (area under the curve [AUC], 0.751; standard error [SE], 0.036; P < 0.001). The best cut-off value for CRP to predict funisitis was 8 mg/L. The sensitivity, specificity, PPV, NPV, LR+, and LR- of an elevated serum CRP level (≥ 8 mg/L) to predict funisitis are shown in Table 2.

Bottom Line: The sensitivity, specificity, positive predictive value, and negative predictive value of an elevated serum CRP level (≥ 8 mg/L) were 74.1%, 67.5%, 32.8%, and 92.4% for funisitis, and 67.7%, 63.3%, 17.2%, and 94.6% for EONS, respectively.Logistic regression analysis demonstrated that elevated levels of serum CRP were significantly associated with funisitis and EONS, even after adjusting gestational age.A low serum CRP level (< 8 mg/L) has good negative predictive value in excluding funisitis and EONS, and may therefore be used as a non-invasive adjunct to clinical judgment to identify low-risk patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
The aim of this study was to determine whether maternal serum C-reactive protein (CRP) is of value in predicting funisitis and early-onset neonatal sepsis (EONS) in women with preterm labor or preterm premature rupture of membranes (PROM). This retrospective cohort study included 306 consecutive women with preterm labor or preterm PROM who delivered preterm singleton neonates (23-35 weeks gestation) within 72 hr of CRP measurement. The CRP level was measured with a highly sensitive immunoassay. The sensitivity, specificity, positive predictive value, and negative predictive value of an elevated serum CRP level (≥ 8 mg/L) were 74.1%, 67.5%, 32.8%, and 92.4% for funisitis, and 67.7%, 63.3%, 17.2%, and 94.6% for EONS, respectively. Logistic regression analysis demonstrated that elevated levels of serum CRP were significantly associated with funisitis and EONS, even after adjusting gestational age. The maternal serum CRP level obtained up to 72 hr before delivery is an independent predictor of funisitis and EONS in women with preterm labor or preterm PROM. A low serum CRP level (< 8 mg/L) has good negative predictive value in excluding funisitis and EONS, and may therefore be used as a non-invasive adjunct to clinical judgment to identify low-risk patients.

Show MeSH
Related in: MedlinePlus