Maternal Serum Haptoglobin Levels as a Marker of Preterm Premature Rupture of Membranes

Gul Nihal Buyuk; Z.Asli Oskovi-Kaplan; Huseyin Durukan

doi:10.1055/a-1167-4512

Zeitschrift für Geburtshilfe und Neonatologie, Table of Contents

Z Geburtshilfe Neonatol 2021; 225(01): 47-50
DOI: 10.1055/a-1167-4512

Original Article

Maternal Serum Haptoglobin Levels as a Marker of Preterm Premature Rupture of Membranes

Gul Nihal Buyuk

¹Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey

,

Z.Asli Oskovi-Kaplan

¹Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey

,

Huseyin Durukan

²Obstetrics and Gynecology, Mersin University, Mersin, Turkey

› Author Affiliations

Abstract

Objective We aimed to investigate the prognostic value of maternal serum haptoglobin levels in patients presenting with preterm premature rupture of fetal membranes (PPROM) during the second and the third trimesters of pregnancy.

Methods In this case control study, 60 patients were recruited (30 pregnant women with PPROM between 26–34 weeks of gestation and 30 healthy, gestational-age-matched pregnant women without PPROM). White blood cell count (WBC), interleukin 6 (IL-6), C-reactive protein (CRP), sedimentation rate, and haptoglobin levels were measured.

Results The mean age, gestational week, gravida, and parity of the 2 groups were statistically comparable (P>0.001). There was a statistically significant difference between the 2 groups in terms of haptoglobin values (p<0.001). The mean haptoglobin level was 115.5+33.1(mg/dl) in the PPROM group and 66.5+42.6 (mg/dl) in the control group. ROC curve analysis was performed to determine whether the level of haptoglobin alone could diagnose PPROM as an independent marker. It was shown that the level of 94.5 mg/dL for haptoglobin could indicate the diagnosis of PPROM with 80% sensitivity and specificity

Conclusion Maternal serum haptoglobin levels may be a diagnostic marker for suspected PPROM cases when membrane rupture diagnosis is not accurate based on physical examination and other diagnostic tests.

Key words

Preterm premature rupture of fetal membranes - Haptoglobin - Preterm birth - acute phase reactants

Full Text

References

References
1 Noor S, Nazar AF, Bashir R. et al. Prevalance of PPROM and its outcome. J Ayub Med Coll Abbottabad 2007; 19: 14-17
2 Practice Bulletin No. 139 Premature rupture of membranes. Obstet Gynecol 2013; 122: 918-930.
3 Trochez-Martinez RD, Smith P, Lamont RF. Use of C-reactive protein as a predictor of chorioamnionitis in preterm prelabour rupture of membranes: a systematic review. BJOG 2007; 114: 796-801. doi:10.1111/j.1471-0528.2007.01385.x
4 Derbent A, Simavlı S. İnegöl Gümüş İ et al. Pregnancy outcome after preterm rupture of the membranes before or after 34 weeks’ gestation in a private tertiary referral hospital. Gynecol Obstet Reprod Med 2010; 16: 135-140
5 Cinkaya A, Keskin HL, Buyukkagnici U. et al. Maternal plasma total antioxidant status in preterm labor. J Obstet Gynaecol Res 2010; 36: 1185-1188
6 Mercer BM, Goldenberg RL, Meis PJ. et al. The Preterm Prediction Study: prediction of preterm premature rupture of membranes through clinical findings and ancillary testing. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol 2000; 183: 738-745
7 Sivan E, Dulitzky M, Lipitz S. et al. The clinical value of umbilical artery Doppler velocimetry in the management of intrauterine growth-retarded fetuses before 32 weeks’ gestation. Gynecol Obstet Invest 1995; 40: 19-23
8 Torbé A, Czajka R. Are vaginal fluid procalcitonin levels useful for the prediction of subclinial infection in patients with preterm premature rupture of membranes?. J Obstet Gynaecol Res 2005; 31: 464-470 doi:10.1111/j.1447-0756.2005.00321.x
9 Hock N, Reuschel E, Aigner F. et al. Neonatal parameters in correlation to non-invasive determination of cytokines in amniotic fluid in preterm premature rupture of membranes (PPROM). Zeitschrift für Geburtshilfe und Neonatologie 2017; 221: P03-P03
10 Quaye IK. Haptoglobin, inflammation and disease. Trans R Soc Trop Med Hyg 2008; 102: 735-742. doi:10.1016/j.trstmh.2008.04.010
11 Katnik I, Dobryszycka W. Enzyme immunoassay to measure low levels of haptoglobin in biological fluids. J Immunoassay 1990; 11: 503-517. doi:10.1080/01971529008055047
12 Haram K, Augensen K, Elsayed S. Serum protein pattern in normal pregnancy with special reference to acute-phase reactants. Br J Obstet Gynaecol 1983; 90: 139-145 doi:10.1111/j.1471-0528.1983.tb08898.x
13 Mi Lee S, Romero R, Lee KA. et al. The frequency and risk factors of funisitis and histologic chorioamnionitis in pregnant women at term who delivered after the spontaneous onset of labor. J Matern Fetal Neonatal Med 2011; 24: 37-42.
14 Scholaske L, Buss C, Wadhwa PD. et al. Acculturation and interleukin (IL)-6 concentrations across pregnancy among Mexican-American women. Brain Behav Immun 2018; 73: 731-735.
15 Dammann O, Brinkhaus MJ, Bartels DB. et al. Immaturity, perinatal inflammation, and retinopathy of prematurity: a multi-hit hypothesis. Early Hum Dev 2009; 85: 325-329.
16 Klein JM. Neonatal morbidity and mortality secondary to premature rupture of membranes. Obstet Gynecol Clin North Am 1992; 19: 265-280
17 ACOG Practice Bulletin No. 80 Premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol 2007; 109: 1007-1019.
18 Okmen Ozkan B, Ekmekci E. Changes in umbilical and cerebral blood flow in pregnancies diagnosed with clinical chorioamnionitis. Is chorioamnionitis predictable?. Gynecol Obstet Reprod Med. 2019 1-5
19 Dulay AT, Buhimschi IA, Zhao G. et al. Compartmentalization of acute phase reactants interleukin-6, C-reactive protein and procalcitonin as biomarkers of intra-amniotic infection and chorioamnionitis. Cytokine 2015; 76: 236-243.
20 Romero R, Chaemsaithong P, Chaiyasit N. et al. CXCL10 and IL-6: markers of two different forms of intra-amniotic inflammation in preterm labor. Am J Reprod Immunol. 2017: 78.
21 McCarthy ME, Buhimschi CS, Hardy JT. et al. Identification of haptoglobin switch-on status in archived placental specimens indicates antenatal exposure to inflammation and potential participation of the fetus in triggering preterm birth. Placenta 2018; 62: 50-57.
22 Gloria-Bottini F, Bottini E. Smoking and the correlation between birth weight and placental weight. Evidence of interaction with maternal haptoglobin phenotype. Eur J Obstet Gynecol Reprod Biol 2015; 185: 136-139. doi:10.1016/j.ejogrb.2014.12.019
23 Cousins LM, Smok DP, Lovett SM. et al. AmniSure placental alpha microglobulin-1 rapid immunoassay versus standard diagnostic methods for detection of rupture of membranes. Am J Perinatol 2005; 22: 317-320.
24 Lecerf M, Vardon D, Morello R. et al. Comparison of diagnostic performance of two tests of premature rupture of membranes (IGFBP-1/PAMG-1) in clinical practice. J Gynecol Obstet Biol Reprod (Paris) 2015; 44: 832-839.