Blood biomarkers for the diagnosis of chorioamnionitis following preterm premature rupture of membranes: a systematic review and meta-analysis of studies since 2020.
Antoine Puravet, Samy Kahouadji, Denis Gallot et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis assessed maternal blood biomarkers for predicting histological or clinical chorioamnionitis in women with preterm premature rupture of membranes (PPROM). Nine studies were included from 631 screened articles. Pooled sensitivity was highest for procalcitonin (83%), while neutrophil-lymphocyte ratio had the highest pooled specificity (82%); overall diagnostic performance was modest, with area under the curve values of 73%–77%. No single biomarker appeared sufficiently accurate for prediction, and recent biomarkers lacked enough studies for meta-analysis.
Key findings
- Pooled sensitivity was 71% for CRP, 73% for white blood cell count, 83% for procalcitonin, and 75% for neutrophil-lymphocyte ratio.
- Pooled specificity was 75% for CRP, 61% for white blood cell count, 41% for procalcitonin, and 82% for neutrophil-lymphocyte ratio.
- Area under the ROC curve ranged from 73% for white blood cell count to 77% for CRP and neutrophil-lymphocyte ratio.
Why it matters
Chorioamnionitis is an important infection risk when deciding between delivery and expectant management after PPROM, and is associated with serious maternal and fetal complications. These pooled results indicate that commonly assessed blood markers offer only modest diagnostic performance, underscoring the difficulty of relying on any one marker to identify affected patients.
What to keep in mind
Only nine studies were included, and no new biomarker had been evaluated frequently enough to permit meta-analysis of its diagnostic accuracy.