International Journal of Nanomedicine (Jan 2022)
Bio-Functionalized Magnetic Nanoparticles for the Immunoassay of C-Reactive Protein and Procalcitonin in Cervicovaginal Secretions of Pregnant Women with Preterm Prelabor Rupture of Membranes to Predict Early-Onset Neonatal Sepsis
Abstract
Sau Xiong Ang,1 Chie-Pein Chen,1 Fang-Ju Sun,2 Chen-Yu Chen1,3 1Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; 2Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; 3Department of Medicine, Mackay Medical College, New Taipei City, TaiwanCorrespondence: Chen-Yu ChenDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, No. 92, Section 2, Zhong-Shan North Road, Taipei, 10449, TaiwanTel +886-2-2543-3535Fax +886-2-2543-3642Email [email protected]: Early-onset sepsis is a major cause of neonatal morbidity and mortality. C-reactive protein (CRP) and procalcitonin (PCT) are acute phase reactants related to infection. The aim of this study was to explore the feasibility of measuring CRP and PCT concentrations in cervicovaginal secretions of pregnant women with preterm prelabor rupture of membranes (PPROM) using an immunomagnetic reduction (IMR) assay to predict early-onset neonatal sepsis.Patients and Methods: This prospective study was performed at Mackay Memorial Hospital, Taipei, Taiwan from February 2015 to January 2018. Pregnant women with PPROM between 22 and 34 weeks of gestation were recruited. CRP and PCT concentrations in cervicovaginal secretions were measured using an IMR assay.Results: Thirty-five cervicovaginal secretion samples were obtained. After excluding two neonatal deaths, early-onset neonatal sepsis was diagnosed in 15 of the 33 surviving neonates. There was no significant relationship between cervicovaginal secretion CRP level and neonatal sepsis; however, cervicovaginal secretion PCT levels were significantly higher in the neonatal sepsis group than in the non-sepsis group (45.99 vs 9.54 ng/mL, P = 0.039). Receiver operating characteristic (ROC) curve analysis revealed a PCT cut-off level of 20.60 ng/mL to predict early-onset sepsis, and the area under the ROC curve was 0.71 (95% confidence interval 0.52 to 0.90, P = 0.039), with sensitivity and specificity of 73.3% and 77.8%, respectively.Conclusion: Measuring the concentration of PCT in cervicovaginal secretions with an IMR assay can predict early-onset sepsis in neonates born to mothers with PPROM.Keywords: C-reactive protein, procalcitonin, immunomagnetic reduction, magnetic nanoparticle, preterm prelabor rupture of membranes, early-onset neonatal sepsis
