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KMID : 0606620080040020075
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Korean Journal of Fetal Medicine
2008 Volume.4 No. 2 p.75 ~ p.81
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Relationship Between on Amniotic Fluid C-Reactive Protein at the Time of Mid-Trimester Genetic Amniocentesis and Subsequent Spontaneous Preterm Delivery
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Park Chan-Wook
Park Joong-Shin
Jun Jong-Kwan
Yoon Bo-Hyun
Lee Seung-Mi
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Abstract
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Objective: The purpose of this study was to determine whether increased amniotic fluid C-reactive protein (CRP)
concentration in mid-trimester is associated with subsequent spontaneous preterm delivery before 32 weeks.
Study design: This case-control study included 18 cases with spontaneous preterm delivery (≤32 weeks) and 90
matched controls those who delivered at term. This study was conducted to compare mid-trimester concentrations of
amniotic fluid CRP in patients who spontaneously delivered before 32 weeks of gestation and in those who delivered
at term with normal outcomes. Patients with abnormal fetal karyotypes, major anomalies, multiple pregnancy or medical
complications, or those with cervical dilatation (>1 cm) or ruptured membranes at the time of amniocentesis were
excluded. Amniotic fluid C-reactive protein was measured by using specific immunoassays.
Results: The median amniotic fluid CRP concentrations in patients with spontaneous preterm delivery (≤32 weeks) were significantly higher than those of control cases (median, 13.5 ng/mL [range, 0.8-572.7 ng/mL] vs median, 4.6 ng/mL [range, 0.2-125.8 ng/mL], P<0.05). Amniotic fluid CRP concentrations higher than 40.0 ng/mL had the highest
specificity and odds ratio (sensitivity, 39% [7/18]; specificity, 90% [81/90]; OR, 5.7 [95% CI, 1.8-18.5]) in the
identification of the patients with spontaneous preterm delivery after mid-trimester genetic amniocentesis.
Conclusions: Elevated mid-trimester concentration of amniotic fluid CRP is a risk factor for early spontaneous
preterm delivery (≤32 weeks).
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KEYWORD
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Pretermdelivery, C-reactiveprotein, Amnioticfluid, Amniocentesis, Mid-trimester
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