Normal value and changes in CRP values on maternal and fetal umbilical cord blood with the labor and intrapartum interventions

Introduction: C-reactive protein (CRP) is widely used as an inflammatory marker. Since labour is an inflammatory process, CRP values vary during the intrapartum and postpartum period due to multiple factors.Methods: A descriptive-analytical study was carried out at Castle Street Hospital for Women. Mothers who have term singleton pregnancies with uneventful antenatal periods and have undergone vaginal delivery were recruited for the study. Samples were obtained just after admission to the labour ward (S1), 24 hours after the delivery (S2), and the fetal umbilical cord blood (S3). Reference ranges for S2 and S3 were determined using the interquartile range (IQR).Results: Out of 300 mothers recruited for the study, the mean age was 26.73 years (95% Confidence interval 19.5-36.9). There were 266 samples of S1,177 samples of S2, and 173 samples of S3 were collected. The reference range for S2 is 12.70-150.83 mg/dl, and for S3 is 0.1-8.1 mg/dL. The S2 value is significantly associated with duration of labor (r=0.47, p=0.046), number of vaginal examinations (VEs) (p < 0.001), augmentation of labor (AOL) (p=0.001), method of cervical ripening (p=0.014) and intrapartum intervention (p < 0.001). The number of vaginal examinations (p=0.02) and augmentation of labor (p=0.025) are significantly associated with fetal umbilical cord blood (S3).Conclusion: Early postpartum CRP can be risen up to 151 mg/dL after 24 hours of vaginal delivery. It may be associated with prolonged labor, number of VEs performed, AOL, method of cervical ripening, and episiotomy. Fluctuation of normal CRP values during the periods of antenatal, intrapartum, and postpartum needs to be assessed in the Sri Lankan community.