Journal
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
Volume 205, Issue -, Pages 133-140Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.ejogrb.2016.08.022
Keywords
Prospective and multicentric study; Maternal seric markers; Prediction; Histological choriomanionitis; C-reactive protein
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Funding
- French Ministry of Health under its clinical research hospital programme
- Apicil group insurance company
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Objective: To assess and compare several maternal seric markers for the prediction of histological chorioamnionitis (HCA) after preterm premature rupture of membranes (PPROM). Study design A prospective and multicentric observational study was undertaken, including six French tertiary referral centres. Pregnant women over 18 years, with PPROM between 22 + 0 and 36+6 WG were enrolled. A blood sample was obtained before delivery and analysed for C-Reactive Protein (CRP), InterCellular Adhesion Molecule-1 (ICAM-1), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Matrix-Metalloproteinase 8 and 9 (MMP-8, MMP-9), Triggering receptor on myeloid cells (TREM-1), and Human Neutrophile Peptides (HNP). HCA was determined by histological examination distinguishing maternal from fetal inflammatory response. Placental analyses and biological assays were performed in duplicate. Comparison of maternal seric markers levels in women with or vs. without HCA was performed, using a non-parametric Receiver Operating Characteristic. Results: 295 women were kept for analysis. The prevalence of HCA was 42.7% (126/295). The concentrations of MMP-8, MMP-9, HNP and CRP were higher in HCA vs. the non-HCA group (P < 0.05) whereas the concentrations of ICAM-1, IL-6, IL-8 were not different (P>0.05). The ROC curve with the largest AUC was for CRP (AUC; 0.70; 95% CI; 0.64-0.77) and it was significantly higher than those for MMP-8, MMP-9, or HNP (P < 0.03). Conclusion: CRP was the best maternal marker for predicting HCA in women with PPROM. (C )2016 Elsevier Ireland Ltd. All rights reserved.
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