Accounts of adverse neonatal effects in preterm prelabor rupture of membranes: anticipating maternal platelet indices and C-reactive protein as effective biomarkers

Abstract

Present study aimed at determining maternal platelet indices in preterm prelabor rupture of membranes with adverse neonatal consequences. Comparing maternal C-reactive protein efficacy and platelet indices in predicting outcomes. Herein, 82 women with preterm prelabor rupture of membranes and 78 women with spontaneous preterm labor were studied. All women undertook complete blood count tests. The group of preterm prelabor rupture of membranes undertook additional C-reactive protein tests. Neonatal outcome data were compiled post-delivery, and results were compared. C-reactive protein efficacy and platelet indices helped in predicting neonatal outcomes in the group of preterm prelabor rupture of membranes using receiver operating characteristic curve analysis. Women with preterm prelabor rupture of membranes had increased levels of mean platelet volume (8.41 vs. 7.66; p<0.0001), platelet crit (0.223 vs. 0.194; p=0.002), and higher prevalence of early-onset neonatal sepsis (19.5% vs. 2.6%; p<0.001) compared to those with spontaneous preterm labor. In the group of preterm prelabor rupture of membranes, mean platelet volume, platelet crit, and C-reactive protein were significantly associated with respiratory distress syndrome and early-onset neonatal sepsis. The cut-off values mean platelet volume ≥ 8.55fL, platelet crit of ≥0.255%, and C-reactive protein of 5mg/L predicted respiratory distress syndrome with an area under the curve of 0.84, 0.92 and 0.72, the sensitivity of 83%, 91%, and 62%, and specificity of 78.1%, 92.2%, and 68.2%, respectively. The cut-off values of mean platelet volume ≥ 9.05 fL, platelet crit of ≥0.283%, and C-reactive protein of 6mg/L predicted early-onset neonatal sepsis with an area under the curve of 0.86, 0.90 and 0.65, sensitivity of 87.5%, 93%, and 56%, and specificity of 75%, 85%, and 66%, respectively. Maternal mean platelet volume and platelet crit are useful predictors of neonatal respiratory distress syndrome and early-onset neonatal sepsis in mothers with preterm prelabor rupture of membranes and werebetter predictors of neonatal outcomes than C-reactive protein.