Plasma ferritin, premature rupture of membranes, and pregnancy outcome

OBJECTIVE: The objective of this study was to determine whether plasma ferr itin levels predict maternal or neonatal outcomes in women with preterm rup ture of membranes at <32 weeks' gestation. METHODS: Plasma from 223 women with premature rupture of membranes at <32 w eeks' gestation who had participated in a randomized antibiotic trial were analyzed for ferritin at random assignment and at delivery, and the results were compared with the development of clinical chorioamnionitis, latency u ntil delivery, neonatal sepsis, and a composite adverse neonatal outcome va riable. RESULTS: The mean plasma ferritin level rose from 19.2 +/- 29.1 mu g/L on a dmission to 38.3 +/- 54.3 mu g/L at delivery, with a mean latency of 9.3 +/ - 14.6 days. Plasma ferritin levels were significantly higher at both times in mothers whose infants acquired sepsis than in those whose infants did n ot, especially at delivery (68.5 +/- 96.3 mu g/L vs 32.5 +/- 40.5 mu g/L, P =.01), and neonatal sepsis was 2 to 3 times more common among women with pl asma ferritin levels above the median than among those with levels below th e median. CONCLUSIONS: Among women with premature rupture of membranes at <32 weeks' gestation, plasma ferritin levels were significantly associated with neonat al sepsis. These data suggest that higher plasma ferritin levels may serve as a marker of infection among women with premature rupture of membranes; h owever, the clinical utility of plasma ferritin levels in predicting neonat al outcome appears limited.