Farah Noor¹, Tripti Rani Das², Jinat Fatema¹, Shah Noor Sharmin³*, Dipika Majumder⁴, Bidisha Chakma⁵, Sabiha Islam⁵ and Tanzina Iveen Chowdhury¹

¹Assistant Professor, Department of Obstetrics and Gynecology, Bangladesh Medical University, Dhaka, Bangladesh
²Professor, Department of Obstetrics and Gynecology, Bangladesh Medical University, Dhaka, Bangladesh
³Medical Officer, Department of Obstetrics and Gynecology, Bangladesh Medical University, Dhaka, Bangladesh.
⁴Medical Officer, Department of Obstetrics and Gynecology, Madaripur, Bangladesh
⁵Associate Professor, Department of Obstetrics and Gynecology, Bangladesh Medical University, Dhaka, Bangladesh

*Corresponding Author: Shah Noor Sharmin, Medical Officer, Department of Obstetrics and Gynecology, Bangladesh Medical University, Dhaka, Bangladesh.

Received: May 19, 2025; Published: June 10, 2025

Abstract

Background: Chorioamnionitis continues a significant reason of maternal and neonatal morbidity, mainly in low-and middle-income countries like Bangladesh and round the Indian subcontinent, where diagnostic challenges frequently interval timely interfering. Universally, the exploration for consistent, available biomarkers such as CRP is important for advancing initial diagnosis and clinical outcomes in settings with controlled resources.

Aim: To measure the level of diagnostic accuracy parameters (sensitivity, specificity, PPV, NPV) of CRP for the diagnosis of chorio amnionitis.

Methods: An experimental study was conducted at Bangladesh Medical University (BMU) from October 2022 to September 2023. A total of 125 pregnant women aged 18–40 years with preterm premature rupture of membranes (PPROM) and singleton pregnancies were registered with suitability sampling. Women with inflammatory terms, obstetric difficulties, or fetal anomalies were excluded. CRP levels were considered, and diagnostic exactness was calculated versus clinical diagnosis of chorioamnionitis. Data was analyzed with SPSS version 26, ensuing ethical consent and informed permission.

Results: Out of 125 contributors, 66.4% were clinically diagnosed with chorioamnionitis. Higher CRP levels (10-30 mg/L) were detected in 62.4% of cases. The diagnostic correctness of CRP for chorioamnionitis confirmed a sensitivity of 91.2%, specificity of 100%, positive prognostic value of 91.2%, and negative predictive value of 100%, representing that CRP is an extremely sensitive and exact marker for diagnosing chorioamnionitis in pregnant women.

Conclusion: CRP confirmed high sensitivity and specificity for diagnosing chorioamnionitis in women with PPROM, assisting its practice as a consistent and available biomarker, especially in source-restricted settings.

Keywords: Chorioamnionitis; C-Reactive Protein; CRP; Diagnostic Accuracy; Sensitivity; Specificity; PPROM; Biomarker; Maternal Infection; Neonatal Outcome

References

1. Xie A., et al. “Related factors and adverse neonatal outcomes in women with preterm premature rupture of membranes complicated by histologic chorioamnionitis”. Medical Science Monitor 21 (2015): 390-395.
2. Wiwanitkit V. “Maternal C-reactive protein for detection of chorioamnionitis: an appraisal”. Infectious Diseases in Obstetrics and Gynecology 3 (2005): 179-181.
3. Bek KM., et al. “C-reactive protein (CRP) and pregnancy”. European Journal of Obstetrics and Gynecology and Reproductive Biology 1 (1990): 29-33.
4. Hirsch W., et al. “C-reactive protein in the maternal serum and risk of maternal infection in premature rupture of membranes”. Zentralblatt für Gynäkologie 21 (1989): 1411-1416.
5. Bek KM., et al. “C-reactive protein in the maternal serum and risk of fetal infection in premature rupture of membranes”. Zentralblatt für Gynäkologie 21 (1989): 1411-1416.
6. van de Laar R., et al. “Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: a systematic review”. European Journal of Obstetrics and Gynecology and Reproductive Biology2 (2009): 124-129.
7. van der Ham DP., et al. “Use of C-reactive protein as a predictor of chorioamnionitis in PPROM: a systematic review”. BJOG 1 (2008): 127-128.
8. Aggarwal A and Pahwa S. “Evaluation of CRP as an early predictor of chorioamnionitis in PPROM”. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 4 (2018): 1361-1365.
9. Popowski T., et al. “Prediction of maternofetal infection in PPROM: serum maternal markers”. Gynécologie Obstétrique Fertilité 5 (2011): 302-308.
10. Kwak DW., et al. “Usefulness of maternal serum CRP with vaginal U. urealyticum for prediction of preterm delivery and chorioamnionitis”. Journal of Perinatal Medicine 4 (2015): 409-415.
11. Asadi N., et al. “Predictive value of procalcitonin, CRP, and WBCs for chorioamnionitis in PPROM”. International Journal of Gynecology and Obstetrics 1 (2019): 83-88.
12. Choi SR, et al. Matrix Metalloproteinase-8 in oral fluid and histologic chorioamnionitis”. Reproductive Sciences 7 (2021): 2023-2028.
13. Chen FC., et al. “LBP in early diagnosis of intraamniotic infection in PPROM”. Journal of Perinatal Medicine 2 (2009): 135-139.
14. Wasunna A., et al. “CRP and bacterial infection in preterm infants”. European Journal of Pediatrics 6 (1990): 424-427.
15. Pollak A. “40 years neonatology: An academic life”. Wien Klin Wochenschr (2024).
16. Bek KM., et al. “CRP in threatened premature labor and infection risk”. Zentralblatt für Gynäkologie 111 (1989): 1411-1416.
17. Wiwanitkit V. “CRP as a marker in maternal infection”. Infectious Diseases in Obstetrics and Gynecology 3 (2005): 179-181.
18. Asadi N., et al. “Predictive value of procalcitonin, C-reactive protein, and white blood cells for chorioamnionitis among women with preterm premature rupture of membranes. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics 1 (2019): 83-88.
19. Kwak DW., et al. “Usefulness of maternal serum C-reactive protein with vaginal Ureaplasma urealyticum as a marker for prediction of imminent preterm delivery and chorioamnionitis in patients with preterm labor or preterm premature rupture of membranes”. Journal of Perinatal Medicine4 (2015): 409-415.

Citation

Citation: Shah Noor Sharmin., et al. “Measures of Diagnostic Accuracy Parameters of C-Reactive Protein (CRP) for Chorioamnionitis". Acta Scientific Paediatrics 8.7 (2025): 12-18.

Copyright

Copyright: © 2025 Shah Noor Sharmin., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.