C-reactive protein velocity and inflammatory burden index: new systemic inflammatory biomarkers and their predictive value for the latent period in preterm premature rupture of membrane pregnancies

Abstract

Objective: This study aimed to evaluate the prognostic value of C-reactive protein velocity (CRPv) and inflammatory burden index (IBI) as novel systemic inflammatory biomarkers in predicting the latent period in pregnancies complicated by preterm premature rupture of membranes (PPROM). We investigated the role of these markers in estimating the timing of delivery and their association with perinatal and neonatal outcomes. Methods: This retrospective cohort study included 337 singleton pregnancies diagnosed with PPROM at Ankara Etlik City Hospital between January 1, 2024, and January 1, 2025. Patients were divided into two groups based on the latency period. Maternal inflammatory markers, CRPv, and IBI, were recorded and analyzed. The relationship between these inflammatory markers and latency period was assessed, and ROC curve analysis was performed to determine optimal cutoff values. Results: CRPv and IBI values were significantly higher in patients with a latency period of less than 48 h compared to those delivering after 48 h (p < 0.001). ROC analysis revealed that CRPv > 0.17 had 70% sensitivity and 67% specificity in predicting delivery within 48 h (AUC = 0.675, p < 0.001), while IBI > 35.8 demonstrated predictive accuracy for early delivery (AUC = 0.563, p = 0.047). Conclusion: CRPv and IBI are promising inflammatory biomarkers for predicting the latency period in PPROM pregnancies. Their incorporation into clinical management may improve risk stratification, aiding in timely interventions to optimize maternal and neonatal outcomes. Further prospective studies are warranted to validate these findings and explore their integration into standard obstetric care.