A systematic review of biomarkers associated with maternal infection in pregnant and postpartum women.

BACKGROUND Serum biomarkers are commonly used to support the diagnosis of infection in non-pregnant patients whose clinical presentation suggests infection. The utility of serum biomarkers for infection in pregnant and postpartum women is uncertain. SEARCH STRATEGY PubMed, CINAHL, EMBASE, ClinicalTrials.gov, Cochrane Library, CINAHL, and SCOPUS were searched from inception to February 2020. Selection criteria Full-text manuscripts in English were included if they reported the measurement of maternal serum biomarkers - and included a control group - to identify infection in pregnant and postpartum women. DATA COLLECTION AND ANALYSIS Two authors independently screened manuscripts, extracted data, and assessed methodological quality. MAIN RESULTS Interleukin 6 (IL-6), c-reactive protein (CRP), procalcitonin (PCT), insulin-like growth factor binding protein 1 (IGFBP-1), tumor necrosis factor alpha (TNF-alpha), calgranulin B, neopterin (NPT), and interferon gamma inducible protein 10 (IP-10) reliably indicated infection. Intercellular adhesion molecule 1 (ICAM-1), monocyte chemotactic and activating factor (MCAF), soluble interleukin 6 receptor (sIL-6R), and interleukin 8 (IL-8) were not useful markers in pregnant and postpartum women. CONCLUSIONS Findings suggest certain biomarkers have diagnostic value when maternal infection is suspected, but also confirms limitations in this population. (CRD42020162321).