Predictors for histological chorioamnionitis among women with preterm
premature rupture of membranes after dexamethasone administration:a
retrospective study
Abstract
Objective: To investigate reliable biomarkers for predicting
histological chorioamnionitis (HCA). Design: In this retrospective
study, PPROM mothers were treated with a course of dexamethasone. Blood
tests for serum indictors were conducted continuously after first
injection. Setting: One Shanghai hospital Population: PPROM mothers
before 34 0/7 weeks of gestation Methods: Data were compared by General
Linear Model analysis. The diagnostic accuracy in predicting HCA were
evaluated with ROC curve. Main Outcome Measures: The response of
infectious indictors to dexamethasone treatment; the diagnostic accuracy
for CRP and PCT in predicting HCA. Results: We found 98 HCA women
(62.42%) and 59 CON women (37.58%) in 157 PPROM mothers. WBC and
neutrophil significantly increased 24 hours after the first injection in
both groups, followed by a decrease at 72 hours post first injection
(P<0.05). No significances were found between two groups in
WBC, neutrophil and lymphocyte. Both CRP and PCT were significantly
higher in the HCA group after first injection. PCT had both high
specificity and sensitivity, especially at the baseline (cutoff, 0.031
ng/ml). Furthermore, the positive predictive values (PPV) of PCT were
respectively 0.946 and 0.960 at 48 (cutoff, 0.049 ng/ml) and 72 (cutoff,
0.051 ng/ml) hours, which were better than the corresponding PPV of CRP.
Conclusion: The response of WBC, neutrophil and lymphocyte to
dexamethasone could be differentiated from uterine infection; PCT could
be a reliable biomarker for early diagnosis of HCA. Funding: Shanghai
Municipal Commission of Health and Family Planning (GWIV-26, 202040128);
Pudong Commission of Health and Family Planning (PW2019D-13).