Institutional members access full text with Ovid®

Share this article on:

Characteristics of Women in Preterm Labor Associated With Elevated C-Reactive Protein Levels

WATTS, HEATHER D. MD; KROHN, MARIJANE A. PhD; HILLIER, SHARON L. PhD; WENER, MARK H. MD; KIVIAT, NANCY B. MD; ESCHENBACH, DAVID A. MD
Obstetrics & Gynecology: October 1993
Characteristics of Women in Preterm Labor Associated With Elevated C-Reactive Protein Levels: PDF Only

Objective: To evaluate clinical, microbiologic, and histologic findings associated with elevated C-reactive protein levels among women in preterm labor or with preterm premature rupture of the membranes (PROM).

Methods: Obstetric data, serum C-reactive protein levels, and amniotic fluid (AF) and chorioamniotic membrane cultures and histology were obtained on 203 women presenting between 22-34 weeks' gestation in preterm labor or with PROM.

Results: Women with C-reactive protein greater than 1.5 mg/dL were more likely to deliver within 7 days of enrollment (54 of 68, 79%) than were women with normal C-reactive protein levels (45 of 135, 33%) (P< .001). The median C-reactive protein levels and association with rapid delivery did not differ between women with intact versus ruptured membranes. Elevated C-reactive protein levels were associated with a positive AF culture among women in preterm labor with intact membranes. To control for confounding by a long interval to delivery, only the group delivering within 7 days was considered for evaluation of C-reactive protein levels and placental and infant outcome. Among women delivering within 7 days, elevated C-reactive protein was associated with the development of clinical chorioamnionitis and with infant death before hospital discharge, but not with a positive membrane culture or histologic chorioamnionitis.

Conclusions: Elevated C-reactive protein appears to be associated with AF infection, delivery within 7 days of admission, and infant death among women delivering preterm, but not with membrane infection or inflammation. Elevated C-reactive protein may be helpful in determining the need for AF culture and in targeting studies of antibiotic therapy among women in preterm labor or with preterm PROM.(Obstet Gynecol 1993;82:509-14)

From the Departments of Obstetrics and Gynecology, Epidemiology, Laboratory Medicine, and Pathology, University of Washington, Seattle, Washington.

© 1993 The American College of Obstetricians and Gynecologists