Lipopolysaccharide binding protein in the early diagnosis of intraamniotic infection of pregnant women with premature rupture of the membranes

Abstract

To investigate whether lipopolysaccharide binding protein (LBP) level is an early marker of intraamniotic infection in pregnant women with premature rupture of the membranes (PROM) and compare it to C-reactive protein (CRP). Seventy-two pregnant women with PROM were included in the study if remained undelivered for more than 24 h. CRP and LBP concentrations were determined in 12-h-intervals and the last value before delivery was correlated with obstetrical data and placenta histology. LBP concentrations ranged from 1.6 to 48.7 microg/mL (median of 16 microg/mL) and CRP concentrations from 0.02 to 6.8 mg/dL (0.64 mg/dL). CRP was significantly elevated when full blown chorioamnionitis was proven by histology (P<0.01) and when the neonates had to be admitted to the intensive care unit because of suspected infection (P<0.05 mg/dL). There were significantly higher LBP levels when fetal tachycardia occurred (20.3 vs. 14.5 microg/mL, P<0.05) and when intraamniotic infection was diagnosed by histology (22.8 vs. 14.1 microg/mL, P<0.005), but the differences were too little to provide prognostic cut-off values. Increase of LBP and CRP levels after PROM seem to reflect intramniotic infection, but no cut-off values could be defined for the prediction of intraamniotic infection.