Plasma ferritin, premature rupture of membranes, and pregnancy outcome.
OBJECTIVE
The objective of this study was to determine whether plasma ferritin levels predict maternal or neonatal outcomes in women with preterm rupture of membranes at <32 weeks' gestation.


METHODS
Plasma from 223 women with premature rupture of membranes at <32 weeks' gestation who had participated in a randomized antibiotic trial were analyzed for ferritin at random assignment and at delivery, and the results were compared with the development of clinical chorioamnionitis, latency until delivery, neonatal sepsis, and a composite adverse neonatal outcome variable.


RESULTS
The mean plasma ferritin level rose from 19.2 +/- 29.1 microgram/L on admission to 38.3 +/- 54.3 microgram/L at delivery, with a mean latency of 9.3 +/- 14.6 days. Plasma ferritin levels were significantly higher at both times in mothers whose infants acquired sepsis than in those whose infants did not, especially at delivery (68.5 +/- 96.3 microgram/L vs 32.5 +/- 40.5 microgram/L, P =.01), and neonatal sepsis was 2 to 3 times more common among women with plasma ferritin levels above the median than among those with levels below the median.


CONCLUSIONS
Among women with premature rupture of membranes at <32 weeks' gestation, plasma ferritin levels were significantly associated with neonatal sepsis. These data suggest that higher plasma ferritin levels may serve as a marker of infection among women with premature rupture of membranes; however, the clinical utility of plasma ferritin levels in predicting neonatal outcome appears limited.
Goldenberg
R L
RL
National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD, USA.
Mercer
B M
BM
Miodovnik
M
M
Thurnau
G R
GR
Meis
P J
PJ
Moawad
A
A
Paul
R H
RH
Bottoms
S F
SF
Das
A
A
Roberts
J M
JM
McNellis
D
D
Tamura
T
T
D000328:Adult; D002821:Chorioamnionitis; D005260:Female; D005293:Ferritins / Q000097:blood*; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood; D011256:Pregnancy Outcome; D012372:ROC Curve; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D018805:Sepsis
D005293:Ferritins