Sensitivity and specificity of plasma nitric oxide metabolites for the diagnosis of intrauterine pneumonia in preterm prelabor rupture of membranes
- Authors: Shalina R.I.1, Anankina A.A.1, Osipov A.N.1, Titov V.Y.1, Spiridonov D.S.1
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Affiliations:
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation
- Issue: No 5 (2023)
- Pages: 59-67
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/516557
- DOI: https://doi.org/10.18565/aig.2023.20
- ID: 516557
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Abstract
Objective: To determine the diagnostic accuracy of nitrite (NO2–) and non-thiolate nitroso compounds (RNO) for the detection of intrauterine pneumonia (IUP) in women with preterm labor and premature rupture of membranes (PROM).
Materials and methods: This cross-sectional study included 87 patients. Plasma NO2–+RNO, serum leukocyte and C-reactive protein levels were assessed in all patients on admission, and genital secretions were examined microscopically and culturally. NO2–+RNO was determined using an enzyme sensor (RF patent #2461831). In addition, birth outcomes and neonatal developmental histories were analyzed. Based on retrospective analysis, five groups were formed: Ia – ≥37 weeks without PROM (n=21); Ib – ≥37 weeks + PROM (n=12), IIa – 220–366 weeks without PROM (n=12); IIb – 220–366 weeks + PROM (without neonatal IUP) (n=14); IIc – 220–366 weeks + PROM (with neonatal IUP) (n=28).
Results: In the presence of IUP, NO2–+RNO values (3.02±0.90 μM) were statistically significantly higher when compared with groups without IUP (p<0.001). There was a statistically significant direct correlation between the presence of neonatal IUP and the level of maternal venous NO metabolites (rs=0.626; p<0.001). ROC analysis showed a sensitivity of 85.2% (95% CI 66.27–95.81) and specificity of 93.33% (95% CI 83.8–98.15) for NO2–+RNO≥2.2 μM.
Conclusion: Determination of maternal venous nitric oxide metabolites has a high diagnostic accuracy for the early detection of IUP in preterm birth complicated by PROM: PPV 85.2% (95% CI 68.77–93.76), NPV 93.33% (95% CI 84.97–97.20). The use of this marker for the diagnosis of IUP will allow a personalized approach to selecting appropriate obstetric management and reducing adverse perinatal outcomes associated with infection.
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About the authors
Raisa I. Shalina
N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation
Email: raisa.shalina@gmail.ru
ORCID iD: 0000-0001-7121-1663
Dr. Med. Sci., Professor at the Academician G.M. Savelyeva Department of Obstetrics and Gynecology, Faculty of Pediatrics
Russian Federation, MoscowAliya A. Anankina
N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation
Author for correspondence.
Email: kuzina.aliya@yandex.ru
ORCID iD: 0000-0002-0223-0868
Postgraduate Student at the Academician G.M. Savelyeva Department of Obstetrics and Gynecology, Faculty of Pediatrics
Russian Federation, MoscowAnatoliy N. Osipov
N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation
Email: anosipov@yahoo.com
ORCID iD: 0000-0001-7244-2818
Corresponding Member of RAS, Dr. Bio. Sci., Professor, Head of the Department of General and Medical Biophysics, Medicobiologic Faculty
Russian Federation, MoscowVladimir Yu. Titov
N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation
Email: vtitov43@yandex.ru
ORCID iD: 0000-0002-2639-7435
Dr. Bio. Sci., Leading Researcher at the Department of Medical Biophysics
Russian Federation, MoscowDmitrii S. Spiridonov
N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation
Email: spiridonov_ds@rsmu.ru
ORCID iD: 0000-0001-8391-7436
PhD, Associate Professor at the Academician G.M. Savelyeva Department of Obstetrics and Gynecology, Faculty of Pediatrics
Russian Federation, MoscowReferences
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