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

Aims: 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). Methods: 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. Results: LBP concentrations ranged from 1.6 to 48.7 mu g/mL (median of 16 mu g/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 mu g/mL, P<0.05) and when intraamniotic infection was diagnosed by histology (22.8 vs. 14.1 mu g/mL, P<0.005), but the differences were too little to provide prognostic cut-off values. Conclusion: 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.