Elevated C-reactive protein levels in histological chorioamnionitis at term: impact of funisitis on term neonates

Abstract

Objective: To compare clinical features and inflammatory effects for mothers and newborns between cases with or without funisitis among histlogical chorioamnionitis (HCA) at term.

Methods: We recruited 42 patients who were diagnosed with HCA at term. The women were classified into group HCA1/2 (HCA without funisitis, n = 22) and group HCA3 (HCA with funisitis, n = 20). Medical records and cardiotocograms were retrospectively reviewed to analyze predelivery maternal signs, abnormal FHR patterns, and neonatal outcomes. Differences between the two groups were evaluated using the Mann–Whitney U-test.

Results: The maternal CRP and WBC level of group HCA3 was observed to be significantly greater than that of group HCA1/2. Moreover, neonatal CRP levels at days 0, 1 and 2 of group HCA3 were significantly greater than of group HCA1/2. The ratios of abnormal FHR patterns of the two groups for recurrent late deceleration and prolonged deceleration were 26% and 43%, respectively, which was not statistically significant between the two groups.

Conclusion: We showed that HCA at term, particularly for funisitis, elevates the levels of maternal and neonatal CRP. Neonatal inflammatory signs, including elevated CRP levels, should be considered when managing cases of abnormal elevated CRP levels during labor at term.

• Inflammation
• infection
• abnormal fetal heart rate pattern
• noninfectious neonates

Acknowledgements

We thank Dr. Seiichirou Shimizu for performing the placental pathological examinations and providing advice regarding pathological approaches.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.