The role of C-Reactive protein as a diagnostic predictor of sepsis in postpartum women
DOI:
https://doi.org/10.61529/idjp.v35i2.571Abstract
Background: Postpartum sepsis remains a leading cause of maternal mortality worldwide, necessitating the evaluation of C-reactive protein (CRP) as an accessible, rapid diagnostic biomarker to improve early detection and patient outcomes.
Material and Methods: This cross-sectional study was conducted at Civil Hospital Karachi over six months. A total of 471 postpartum women (aged 20–45 years) with suspected sepsis (qSOFA ≥2) within six weeks of delivery were included using non-probability consecutive sampling. Blood samples for quantitative CRP and culture were obtained prior to antibiotic administration. CRP ≥50 mg/L was considered elevated. Diagnostic indices included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and receiver operating characteristic (ROC) analysis.
Results: The mean age was 29.4 ± 5.8 years. Blood culture confirmed sepsis in 370 (78.6%) patients. Elevated CRP (≥50 mg/L) was observed in 356 (75.6%) patients. CRP demonstrated sensitivity of 84.3% (95% CI: 80.2–87.8), specificity of 56.4% (95% CI: 46.2–66.2), PPV of 87.6% (95% CI: 83.7–90.8), NPV of 49.6% (95% CI: 40.2–58.9), and diagnostic accuracy of 78.3% (95% CI: 74.3–81.9). The AUC was 0.71 (95% CI: 0.66–0.76).
Conclusion: CRP ≥50 mg/L demonstrates a satisfactory level of sensitivity and good overall test diagnostic accuracy in identifying postpartum sepsis in a high-prevalence tertiary care environment. Serial CRP measurements can also be used to measure therapeutic responses.
Keywords: C-reactive protein, Diagnostic accuracy, Maternal sepsis, Postpartum period, Sensitivity and specificity
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