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Maternal risk score for the prediction of fetal inflammatory response syndrome after preterm premature rupture of membranes
Author(s) -
Nakahara Mariko,
Goto Shunji,
Kato Eiji,
Nojiri Shuko,
Itakura Atsuo,
Takeda Satoru
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14414
Subject(s) - medicine , prom , premature rupture of membranes , receiver operating characteristic , logistic regression , umbilical cord , white blood cell , obstetrics , area under the curve , gestational age , fetus , predictive value of tests , gestation , pregnancy , immunology , biology , genetics
Aim Preterm premature rupture of membranes (PPROM) is common in preterm births. Fetal inflammatory response syndrome (FIRS) is present in nearly 50% of PPROM cases. We created a risk score to predict FIRS using maternal factors after PPROM. Methods We conducted a retrospective study of singleton pregnancies complicated by PPROM that resulted in delivery at 23–35 weeks of gestation. Antepartum maternal factors and umbilical cord blood interleukin‐6 (IL‐6) data were analyzed. FIRS was defined as IL‐6 > 11 pg/mL. Results Umbilical cord blood IL‐6 and maternal blood data within 24 h before parturition were available for 158 cases; 66 were diagnosed with FIRS (41.8%; median IL‐6, 57.55 pg/mL). We created a risk score (FIRS score) comprising expected delivery weeks (≤30 weeks), maternal C‐reactive protein (≥1.2 mg/dL), maternal white blood cell count (≥13 000/μL), corticosteroid use (none) and PROM latency period (≥3 days) from the multivariate logistic regression model predicting FIRS. Receiver operating characteristic curve analysis of the score produced the following results: area under the curve, 0.82; 95% CI, 0.76–0.89; cut‐off value, 7.5; sensitivity, 89%; specificity, 63%; positive predictive value, 63% and negative predictive value, 89%. The probability of FIRS according to the categories of the FIRS score was 11% for those with a score of 0–7, 50% for a score of 8–15, and 88% for a score of 16–22. Conclusion The devised maternal risk score could predict FIRS and be helpful to decide the delivery timing for the cases of PPROM.