Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective study
Abstract Background This study aimed to investigate the effect of the pathological staging of acute histological chorioamnionitis (HCA) on laboratory indicators and to conduct further studies to reassess the threshold values used by clinicians to identify acute HCA in febrile parturients undergoing...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-023-06026-1 |
| _version_ | 1797451137481179136 |
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| author | Chenyang Xu Chong Fan Jingjing Zhang Xin Zeng Yuru Fan Shanwu Feng |
| author_facet | Chenyang Xu Chong Fan Jingjing Zhang Xin Zeng Yuru Fan Shanwu Feng |
| author_sort | Chenyang Xu |
| collection | DOAJ |
| description | Abstract Background This study aimed to investigate the effect of the pathological staging of acute histological chorioamnionitis (HCA) on laboratory indicators and to conduct further studies to reassess the threshold values used by clinicians to identify acute HCA in febrile parturients undergoing epidural analgesia. Methods A retrospective study of febrile mothers receiving epidural analgesia at Nanjing Maternal and Child Health Care Hospital from January 1, 2018 to December 31, 2018. The participants were grouped by the progression of acute HCA, and the laboratory parameters were compared between groups. The ability of C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and monocyte-leukocyte ratio (M%), alone or in combination, to identify acute HCA in febrile parturients undergoing epidural analgesia was assessed using logistic regression and ROC curves. Results The area under the curve (AUC) of the best logistic regression model predicting HCA climbed to 0.706 (CRP + MLR). Maternal CRP, NLR, and MLR significantly and progressively increased with the progression of acute HCA (p < 0.0001). Based on the ROC curves, the following thresholds were selected to define increased laboratory indicators for identifying acute HCA: CRP ≥ 6.90 mg/L, NLR ≥ 11.93, and MLR ≥ 0.57. In addition, the AUC of the best logistic regression model predicting HCA ≥ stage 2 was 0.710, so these inflammatory markers were more precise in predicting HCA ≥ stage 2. Conclusion Increased CRP (≥ 6.90 mg/L), NLR (≥ 11.93), and MLR (≥ 0.57) may help clinicians to identify early potential acute HCA in febrile parturients receiving epidural analgesia and to monitor progression to optimize clinical treatment options. Trial registration The study was registered in the Chinese Clinical Trial Registry on November 24, 2021 ( http://www.chictr.org.cn , ChiCTR2100053554). |
| first_indexed | 2024-03-09T14:50:29Z |
| format | Article |
| id | doaj.art-89bebb199883486a9913d1e96137ce05 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-09T14:50:29Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-89bebb199883486a9913d1e96137ce052023-11-26T14:30:32ZengBMCBMC Pregnancy and Childbirth1471-23932023-11-0123111010.1186/s12884-023-06026-1Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective studyChenyang Xu0Chong Fan1Jingjing Zhang2Xin Zeng3Yuru Fan4Shanwu Feng5Department of Anesthesiology, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalDepartment of Emergency, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalDepartment of Delivery Room, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalDepartment of Medical Research Center, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalDepartment of Delivery Room, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalDepartment of Anesthesiology, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalAbstract Background This study aimed to investigate the effect of the pathological staging of acute histological chorioamnionitis (HCA) on laboratory indicators and to conduct further studies to reassess the threshold values used by clinicians to identify acute HCA in febrile parturients undergoing epidural analgesia. Methods A retrospective study of febrile mothers receiving epidural analgesia at Nanjing Maternal and Child Health Care Hospital from January 1, 2018 to December 31, 2018. The participants were grouped by the progression of acute HCA, and the laboratory parameters were compared between groups. The ability of C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and monocyte-leukocyte ratio (M%), alone or in combination, to identify acute HCA in febrile parturients undergoing epidural analgesia was assessed using logistic regression and ROC curves. Results The area under the curve (AUC) of the best logistic regression model predicting HCA climbed to 0.706 (CRP + MLR). Maternal CRP, NLR, and MLR significantly and progressively increased with the progression of acute HCA (p < 0.0001). Based on the ROC curves, the following thresholds were selected to define increased laboratory indicators for identifying acute HCA: CRP ≥ 6.90 mg/L, NLR ≥ 11.93, and MLR ≥ 0.57. In addition, the AUC of the best logistic regression model predicting HCA ≥ stage 2 was 0.710, so these inflammatory markers were more precise in predicting HCA ≥ stage 2. Conclusion Increased CRP (≥ 6.90 mg/L), NLR (≥ 11.93), and MLR (≥ 0.57) may help clinicians to identify early potential acute HCA in febrile parturients receiving epidural analgesia and to monitor progression to optimize clinical treatment options. Trial registration The study was registered in the Chinese Clinical Trial Registry on November 24, 2021 ( http://www.chictr.org.cn , ChiCTR2100053554).https://doi.org/10.1186/s12884-023-06026-1BiomarkersC-reactive proteinEpidural hyperthermiaHistological chorioamnionitisMonocyte-lymphocyte ratioNeutrophil-lymphocyte ratio |
| spellingShingle | Chenyang Xu Chong Fan Jingjing Zhang Xin Zeng Yuru Fan Shanwu Feng Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective study BMC Pregnancy and Childbirth Biomarkers C-reactive protein Epidural hyperthermia Histological chorioamnionitis Monocyte-lymphocyte ratio Neutrophil-lymphocyte ratio |
| title | Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective study |
| title_full | Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective study |
| title_fullStr | Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective study |
| title_full_unstemmed | Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective study |
| title_short | Laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia: a retrospective study |
| title_sort | laboratory markers to identify acute histological chorioamnionitis in febrile parturients undergoing epidural analgesia a retrospective study |
| topic | Biomarkers C-reactive protein Epidural hyperthermia Histological chorioamnionitis Monocyte-lymphocyte ratio Neutrophil-lymphocyte ratio |
| url | https://doi.org/10.1186/s12884-023-06026-1 |
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