A systematic review of biomarkers associated with maternal infection in pregnant and postpartum women

• Published in: International journal of gynecology and obstetrics Vol. 157; no. 1; pp. 42 - 50
• Main Authors: Oben, Ayamo G., Johnson, Brittany M., Tita, Alan T. N., Andrews, William W., Hibberd, Patricia L., Subramaniam, Akila, Sinkey, Rachel G.
• Format: Journal Article
• Language: English
• Published: United States 01-04-2022
• Subjects: Biomarkers; chorioamnionitis; Female; Humans; maternal morbidity; maternal mortality; Postpartum Period; Pregnancy; puerperal infection; sepsis; systematic review; biomarkers; maternal morbidity; puerperal infection; chorioamnionitis; systematic review; maternal mortality; sepsis
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.13747

Background
Serum biomarkers are commonly used to support the diagnosis of infection in non‐pregnant patients whose clinical presentation suggests infection. The utility of serum biomarkers for infection in pregnant and postpartum women is uncertain.
Search strategy
PubMed, CINAHL, EMBASE, ClinicalTrials.gov, Cochrane Library, CINAHL, and SCOPUS were searched from inception to February 2020.
Selection criteria
Full‐text manuscripts in English were included if they reported the measurement of maternal serum biomarkers—and included a control group—to identify infection in pregnant and postpartum women. Data collection and analysis: two authors independently screened manuscripts, extracted data, and assessed methodologic quality.
Main results
Interleukin‐6 (IL‐6), C‐reactive protein, procalcitonin, insulin‐like growth factor binding protein 1, tumor necrosis factor‐α, calgranulin B, neopterin, and interferon‐γ inducible protein 10 reliably indicated infection. Intercellular adhesion molecule 1, monocyte chemotactic and activating factor, soluble IL‐6 receptor, and IL‐8 were not useful markers in pregnant and postpartum women.
Conclusions
Findings suggest that certain biomarkers have diagnostic value when maternal infection is suspected, but also confirms limitations in this population.
This systematic review identified several serum biomarkers that are consistently elevated in pregnant and postpartum women with a clinical diagnosis of infection.