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      KCI등재 SCI SCIE SCOPUS

      Positive Maternal C-Reactive Protein Predicts Neonatal Sepsis

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      https://www.riss.kr/link?id=A101618040

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      다국어 초록 (Multilingual Abstract)

      Purpose: To evaluate the diagnostic performance of maternal inflammatory marker:C-reactive protein (CRP) in predicting early onset neonatal sepsis (that occurring within 72 hours after birth). Materials and Methods: 126 low birth weight newborns (gest...

      Purpose: To evaluate the diagnostic performance of maternal inflammatory marker:C-reactive protein (CRP) in predicting early onset neonatal sepsis (that occurring within 72 hours after birth). Materials and Methods: 126 low birth weight newborns (gestation 32±3.2 wk, birth weight 1887±623 g) and their mothers were included. Neonates were divided into sepsis group (n=51) including both proven (positive blood culture) and suspected (negative blood culture but with more than 3 abnormal clinical signs), and controls (n=75). Mothers were subgrouped into CRP positive ≥1.22 mg/dL (n=48) and CRP negative <1.22 mg/dL (n=78) group, determined by Receiver Operating Characteristic curves, and odds ratio was calculated for neonatal sepsis according to maternal condition. Results: Maternal CRP was significantly higher in neonatal sepsis group than in control (3.55±2.69 vs. 0.48±0.31 mg/dL, p=0.0001). Maternal CRP (cutoff value >1.22 mg/dL) had sensitivity 71% and specificity 84% for predicting neonatal sepsis. Maternal CRP positive group had more neonatal sepsis than CRP negative group (71% vs. 29%, p<0.001). Odds ratio of neonatal sepsis in maternal CRP positive group versus CRP negative group was 10.68 (95% confidence interval: 4.313-26.428, p<0.001). Conclusion: The risk of early onset neonatal sepsis significantly increased in the case of positive maternal CRP (≥1.22 mg/dL). In newborn of CRP positive mother,the clinician may be alerted to earlier evaluation for possible neonatal infection prior to development of sepsis.

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      참고문헌 (Reference)

      1 Celik IH, "What are the cut-off levels for IL-6 and CRP in neonatal sepsis?" 24 : 407-412, 2010

      2 Trochez-Martinez RD, "Use of C-reactive protein as a predictor of chorioamnionitis in preterm prelabour rupture of membranes: a systematic review" 114 : 796-801, 2007

      3 Beck JR, "The use of relative operating characteristic (ROC) curves in test performance evaluation" 110 : 13-20, 1986

      4 Yoon BH, "Serum C-reactive protein, white blood cell count, and amniotic fluid white blood cell count in women with preterm premature rupture of membranes" 88 : 1034-1040, 1996

      5 Mehr SS, "Sepsis in neonatal intensive care in the late 1990s" 38 : 246-251, 2002

      6 Martius JA, "Risk factors associated with early-onset sepsis in premature infants" 85 : 151-158, 1999

      7 Schuchat A, "Risk factors and opportunities for prevention of early-onset neonatal sepsis: a multicenter case-control study" 105 (105): 21-26, 2000

      8 전가원, "Risk Factors of Transfusion in Anemia of Very Low Birth Weight Infants" 연세대학교의과대학 54 (54): 366-373, 2013

      9 Picklesimer AH, "Racial differences in C-reactive protein levels during normal pregnancy" 199 : 523-, 2008

      10 Edmond K, "New approaches to preventing, diagnosing, and treating neonatal sepsis" 7 : e1000213-, 2010

      1 Celik IH, "What are the cut-off levels for IL-6 and CRP in neonatal sepsis?" 24 : 407-412, 2010

      2 Trochez-Martinez RD, "Use of C-reactive protein as a predictor of chorioamnionitis in preterm prelabour rupture of membranes: a systematic review" 114 : 796-801, 2007

      3 Beck JR, "The use of relative operating characteristic (ROC) curves in test performance evaluation" 110 : 13-20, 1986

      4 Yoon BH, "Serum C-reactive protein, white blood cell count, and amniotic fluid white blood cell count in women with preterm premature rupture of membranes" 88 : 1034-1040, 1996

      5 Mehr SS, "Sepsis in neonatal intensive care in the late 1990s" 38 : 246-251, 2002

      6 Martius JA, "Risk factors associated with early-onset sepsis in premature infants" 85 : 151-158, 1999

      7 Schuchat A, "Risk factors and opportunities for prevention of early-onset neonatal sepsis: a multicenter case-control study" 105 (105): 21-26, 2000

      8 전가원, "Risk Factors of Transfusion in Anemia of Very Low Birth Weight Infants" 연세대학교의과대학 54 (54): 366-373, 2013

      9 Picklesimer AH, "Racial differences in C-reactive protein levels during normal pregnancy" 199 : 523-, 2008

      10 Edmond K, "New approaches to preventing, diagnosing, and treating neonatal sepsis" 7 : e1000213-, 2010

      11 Skrablin S, "Maternal plasma interleukin-6, interleukin-1beta and C-reactive protein as indicators of tocolysis failure and neonatal outcome after preterm delivery" 20 : 335-341, 2007

      12 Yoon BH, "Maternal blood C-reactive protein, white blood cell count, and temperature in preterm labor: a comparison with amniotic fluid white blood cell count" 87 : 231-237, 1996

      13 van der Heyden JL, "Is it useful to measure C-reactive protein and leukocytes in patients with prelabor rupture of membranes?" 27 : 543-547, 2010

      14 Goldenberg RL, "Intrauterine infection and preterm delivery" 342 : 1500-1507, 2000

      15 Asrat T, "Intra-amniotic infection in patients with preterm prelabor rupture of membranes. Pathophysiology, detection, and management" 28 : 735-751, 2001

      16 Seaward PG, "International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term. Premature Rupture of the Membranes" 179 (179): 635-639, 1998

      17 Romero R, "Inflammation in pregnancy: its roles in reproductive physiology, obstetrical complications, and fetal injury" 65 (65): S194-S202, 2007

      18 Goldenberg RL, "Epidemiology and causes of preterm birth" 371 : 75-84, 2008

      19 Bender L, "Early and late markers for the detection of early-onset neonatal sepsis" 55 : 219-223, 2008

      20 Zimmerman MA, "Diagnostic implications of C-reactive protein" 138 : 220-224, 2003

      21 Young Infants Clinical Signs Study Group, "Clinical signs that predict severe illness in children under age 2 months: a multicentre study" 371 : 135-142, 2008

      22 Pfeiffer KA, "Clinical application of maternal serum cytokine determination in premature rupture of membranes--interleukin-6, an early predictor of neonatal infection?" 78 : 774-778, 1999

      23 Stoll BJ, "Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants" 347 : 240-247, 2002

      24 NICE clinical guidesines, "CG Antibiotics for early-onset neonatal infection: antibiotics for the prevention and treatment of early-onset neonatal infection" National Institute for Health and Clinical Excellence 2012

      25 Hirsch W, "C-reactive protein in the maternal serum and risk of fetal infection in premature rupture of the fetal membranes and threatened premature labor" 111 : 141-1416, 1989

      26 Yoon BH, "Amniotic fluid interleukin-6: a sensitive test for antenatal diagnosis of acute inflammatory lesions of preterm placenta and prediction of perinatal morbidity" 172 : 960-970, 1995

      27 Eschenbach DA, "Amniotic fluid infection and cerebral palsy. Focus on the fetus" 278 : 247-248, 1997

      28 Irwin RJ, "A principled approach to setting optimal diagnostic thresholds: where ROC and indifference curves meet" 22 : 230-234, 2011

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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 1.42 0.3 0.99
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
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