Neonatal C-reactive protein value in prediction of outcome of preterm premature rupture of membranes: comparison of singleton and twin pregnancies.
OBJECTIVE
The clinical importance of preterm premature rupture of the membranes (PPROM) is its relationship to maternal and neonatal mortality and morbidity, especially in twin pregnancies. The aim of this study was to determine and compare the role of inflammatory factors as predictors of the PPROM outcome between singleton and twin pregnancies.


METHODS
The medical records of 22 twins delivered between 28 and 34 weeks and complicated by PPROM were reviewed at the Al-Zahra Hospital in Tabriz, Iran. Also among singletons, 55 cases of matched gestational age were randomly selected as a control group. Three laboratory indices of neonatal white blood cell (WBC) count and C-reactive protein (CRP) in the two groups were measured immediately after delivery and the effects of two factors on neonatal outcome were assessed.


RESULTS
In singletons, there was adverse relationship between the mean of WBC count and duration of latency (P = 0.007). Also, a positive relationship between the means of ventilation time and WBC count in second twins was found (P = 0.034). Positive CRP was the main predictor of neonatal intensive care unit admission in both singletons (odds ratio: 4.929, P = 0.042) and first twins (odds ratio: 9.000, P = 0.005). However, positive CRP did not influence the existence of metabolic acidosis or duration of latency in either of the two groups.


CONCLUSIONS
Neonatal WBC count was a predictor for the duration of latency in singletons and for ventilation time in twins. Positive neonatal CRP was an important factor for the prediction of neonatal intensive care unit admission in both types of pregnancy; its role in twins is clearer than in singletons.
Taghavi
Simin
S
Obstetrics and Gynecology Department, Al-Zahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. swt_f@yahoo.com
Melli
Manijeh Sayyah
MS
Barband
Alireza
A
Atashkhoui
Simin
S
Sheikhvatan
Mehrdad
M
D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D014427:Twins
D002097:C-Reactive Protein