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Obstetrics and Gynecology, 87(2), 231-237, 1996

Maternal blood C-reactive protein, white blood cell count, and temperature in preterm labor: a comparison with amniotic fluid white blood cell count

Byungun Yoon , Ji Eun Jun , K PARK

Author affiliations (2)
  • Seoul National University ROR
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development ROR
DOI10.1016/0029-7844(95)00380-0 PMID8559530
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Abstract

Objective

To compare the diagnostic and prognostic performance of maternal blood C-reactive protein, white blood cell count (WBC), and temperature with that of amniotic fluid (AF) WBC in preterm labor.

Methods

One hundred two women with preterm labor and intact membranes were studied. Maternal blood was collected to measure C-reactive protein concentration and WBC, and maternal temperature was also measured. Amniotic fluid obtained by amniocentesis was cultured and WBC determined. Receiver operating characteristic curve, logistic regression, and survival techniques were used for analysis.

Results

Patients with acute histologic chorioamnionitis had significantly higher median C-reactive protein concentration, WBC, temperature, and AF WBC than patients without this lesion (P < .05). Receiver operating characteristic curve and survival analysis demonstrated that an elevated C-reactive protein, WBC, or AF WBC was strongly associated with the likelihood of histologic chorioamnionitis, shorter interval to delivery, clinical chorioamnionitis, and neonatal morbidity (P < .05 for each). Of all the tests, AF WBC was the best independent predictor of a positive AF culture (odds ratio [OR] 16.8), interval to delivery (hazard ratio 5.7), clinical chorioamnionitis (OR 15.2), neonatal sepsis (OR 16.8), and significant neonatal complications (OR 7.4), after other confounding variables were adjusted (P < .05 for each).

Conclusion

An elevated C-reactive protein, WBC, or AF WBC identified patients with intrauterine infection and adverse perinatal outcomes. Amniotic fluid WBC was a better independent predictor of these outcomes than C-reactive protein, WBC, or temperature.

Topics

pregnancy/preterm-birth/infection-and-inflammationbirth-and-delivery/labor-and-birth/induction-of-labor
C-reactive protein white blood cell count preterm labor infection, maternal blood markers chorioamnionitis preterm labor diagnosis, amniotic fluid white blood cell count intrauterine infection, preterm labor intact membranes amniocentesis infection markers, Yoon Romero maternal inflammatory markers preterm delivery prediction, histologic chorioamnionitis CRP WBC diagnostic performance, amniotic fluid culture positive preterm labor predictors, neonatal sepsis intrauterine infection preterm labor biomarkers, receiver operating characteristic CRP amniotic fluid WBC chorioamnionitis, subclinical intrauterine infection preterm labor maternal temperature
PMID 8559530 8559530 DOI 10.1016/0029-7844(95)00380-0 10.1016/0029-7844(95)00380-0 Yoon et al. 1996, Yoon 1996

Cite this article

Yoon, B. H., Yang, S. H., Jun, J. K., Park, K. H., Kim, C. J., & Romero, R. (1996). Maternal blood C-reactive protein, white blood cell count, and temperature in preterm labor: a comparison with amniotic fluid white blood cell count. Obstetrics and gynecology, 87(2), 231-237. https://doi.org/10.1016/0029-7844(95)00380-0

Keywords

Acute Disease, Amniotic Fluid/cytology, Body Temperature, C-Reactive Protein/analysis, Chorioamnionitis/diagnosis/mortality, Female, Humans, Infant, Newborn, Infant, Newborn, Diseases/epidemiology, Leukocyte Count, Logistic Models, Obstetric Labor, Premature/blood, Odds Ratio, Pregnancy, Prognosis, ROC Curve, Survival Rate, C-Reactive Protein

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