Predictive value of procalcitonin or c-reactive protein for subclinical intrauterine infection in patients with premature rupture of membranes (PROM).

Introduction: to evaluate the diagnostic value of procalcitonin (PCT) and C-reactive protein (CRP) for the prediction of subclinical intrauterine infection in patients with premature rupture of membranes (PROM).

Methods: a retrospective analysis was performed based on patients with PROM admitted into our hospital between January 2011 and January 2016. Using the pathological diagnosis of placenta as the gold standard, the sensitivities, specificities, positive predictive values, and negative predictive values of PCT and CRP for the diagnosis of subclinical intrauterine infection at different gestational weeks were analyzed. Further, the diagnostic accuracies were compared according to their receiver operating characteristic (ROC) curves.

Results: 276 cases were included. The area under the ROC curve of CRP is 0.632, and it is significantly better than PCT. The sensitivity, specificity, positive predictive value, and negative predictive value of CRP are 0.686, 0.958, 0.501, and 0.765, which are all better than those of PCT. The group analysis according to different gestational weeks demonstrated that for the group of 28-33+6 weeks pregnant women, the area under the ROC curve of CRP and PCT is 0.869, and 0.787. The both test have satisfactory accuracy. But the sensitivity and specificity of PCT is 0.830, and 0.950, respectively. That are significantly better than CRP.

Conclusion: both PCT and CRP have good application potential for the diagnostic prediction of subclinical intrauterine infection in <34 gestational weeks pregnant women with PROM, and PCT is more applicable to 28-33+6 gestational weeks pregnant women with PROM.