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C反应蛋白变化率和炎症负荷指数:新的全身炎症生物标志物及其对胎膜早破早产妊娠潜伏期的预测价值。

C-reactive protein velocity and inflammatory burden index: new systemic inflammatory biomarkers and their predictive value for the latent period in preterm premature rupture of membrane pregnancies.

作者信息

Duygulu Bulan Dilara, Mutlu Sutcuoglu Bengu, Karabay Gulsan, Seyhanli Zeynep, Vanli Tonyali Nazan, Ozkan Halis Dogukan, Celen Sevki

机构信息

Department of Obstetrics and Gynecology, Division of Perinatology, Ankara Etlik City Hospital, 06170, Ankara, Turkey.

Department of Obstetrics and Gynecology, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey.

出版信息

Arch Gynecol Obstet. 2025 Jun 28. doi: 10.1007/s00404-025-08089-1.

Abstract

OBJECTIVE

This study aimed to evaluate the prognostic value of C-reactive protein velocity (CRPv) and inflammatory burden index (IBI) as novel systemic inflammatory biomarkers in predicting the latent period in pregnancies complicated by preterm premature rupture of membranes (PPROM). We investigated the role of these markers in estimating the timing of delivery and their association with perinatal and neonatal outcomes.

METHODS

This retrospective cohort study included 337 singleton pregnancies diagnosed with PPROM at Ankara Etlik City Hospital between January 1, 2024, and January 1, 2025. Patients were divided into two groups based on the latency period. Maternal inflammatory markers, CRPv, and IBI, were recorded and analyzed. The relationship between these inflammatory markers and latency period was assessed, and ROC curve analysis was performed to determine optimal cutoff values.

RESULTS

CRPv and IBI values were significantly higher in patients with a latency period of less than 48 h compared to those delivering after 48 h (p < 0.001). ROC analysis revealed that CRPv > 0.17 had 70% sensitivity and 67% specificity in predicting delivery within 48 h (AUC = 0.675, p < 0.001), while IBI > 35.8 demonstrated predictive accuracy for early delivery (AUC = 0.563, p = 0.047).

CONCLUSION

CRPv and IBI are promising inflammatory biomarkers for predicting the latency period in PPROM pregnancies. Their incorporation into clinical management may improve risk stratification, aiding in timely interventions to optimize maternal and neonatal outcomes. Further prospective studies are warranted to validate these findings and explore their integration into standard obstetric care.

摘要

目的

本研究旨在评估C反应蛋白速度(CRPv)和炎症负荷指数(IBI)作为新型全身炎症生物标志物在预测胎膜早破(PPROM)合并妊娠潜伏期方面的预后价值。我们研究了这些标志物在估计分娩时间方面的作用及其与围产期和新生儿结局的关联。

方法

这项回顾性队列研究纳入了2024年1月1日至2025年1月1日期间在安卡拉埃特利克市立医院诊断为PPROM的337例单胎妊娠。根据潜伏期将患者分为两组。记录并分析母体炎症标志物、CRPv和IBI。评估这些炎症标志物与潜伏期之间的关系,并进行ROC曲线分析以确定最佳临界值。

结果

潜伏期小于48小时的患者的CRPv和IBI值显著高于48小时后分娩的患者(p < 0.001)。ROC分析显示,CRPv > 0.17在预测48小时内分娩时具有70%的敏感性和67%的特异性(AUC = 0.675,p < 0.001),而IBI > 35.8对早产具有预测准确性(AUC = 0.563,p = 0.047)。

结论

CRPv和IBI是预测PPROM妊娠潜伏期的有前景的炎症生物标志物。将它们纳入临床管理可能会改善风险分层,有助于及时进行干预以优化母婴结局。有必要进行进一步的前瞻性研究来验证这些发现,并探索将它们纳入标准产科护理的方法。

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