Plasma ferritin, premature rupture of membranes, and pregnancy outcome, , ,

Objective: The objective of this study was to determine whether plasma ferritin levels predict maternal or neonatal outcomes in women with preterm rupture of membranes at <32 weeks’ gestation. Methods: Plasma from 223 women with premature rupture of membranes at <32 weeks’ 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 until delivery, neonatal sepsis, and a composite adverse neonatal outcome variable. Results: The mean plasma ferritin level rose from 19.2 ± 29.1 μg/L on admission to 38.3 ± 54.3 μg/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 not, especially at delivery (68.5 ± 96.3 μg/L vs 32.5 ± 40.5 μg/L, P = .01), and neonatal sepsis was 2 to 3 times more common among women with plasma ferritin levels above the median than among those with levels below the median. Conclusions: Among women with premature rupture of membranes at <32 weeks’ gestation, plasma ferritin levels were significantly associated with neonatal sepsis. These data suggest that higher plasma ferritin levels may serve as a marker of infection among women with premature rupture of membranes; however, the clinical utility of plasma ferritin levels in predicting neonatal outcome appears limited. (Am J Obstet Gynecol 1998;179:1599-604.)