Relationship of the C-reactive protein/albumin ratio and the albumin-bilirubin score with latency period and perinatal outcomes in preterm premature rupture of membranes.

OBJECTIVE

This study aimed to evaluate the associations of the C-reactive protein-to-albumin ratio (CAR index) and the albumin-bilirubin (ALBI) score with latency duration and adverse perinatal outcomes among patients with preterm premature rupture of membranes (PPROM).

MATERIALS AND

METHODS

This was a single-center, retrospective study conducted at a tertiary care center. This study included 218 singleton pregnancies followed by a diagnosis of PPROM before 34 weeks of gestation between January 2022 and December 2025. Patients were divided into three groups according to the latency period: delivery within the first 48 h (n = 92, 42%-Group 1), delivery between 48 h and 7 days (n = 56, 25.7%-Group 2), and delivery after 7 days (n = 70, 32.1%-Group 3). First, the associations of the CAR index and ALBI score with latency period were evaluated across all three groups. Subsequently, the associations of the CAR index and ALBI score with neonatal outcomes were examined.

RESULTS

The CAR index was significantly higher in Groups 1 and 2 than in Group 3 (P < 0.001). The CAR index showed discriminatory ability for delivery within 48 h and within 7 days, with sensitivities of 82.3% and 66.2%, respectively. In subgroup analysis, a higher maternal ALBI score was significantly associated with neonatal umbilical artery pH <7.20 and showed discriminatory ability for identifying this outcome, with a sensitivity of 62.2% (P = 0.004).

CONCLUSION

In patients with PPROM, the CAR index was associated with shorter latency and showed discriminatory ability for delivery within the first 48 h and within the first 7 days, whereas a higher ALBI score was significantly associated with neonatal umbilical artery pH <7.20.