Amniotic Fluid Infection in Preterm Pregnancies with Intact Membranes

توضیحات

ABSTRACT

Intra-amniotic infection (IAI) is a major cause of preterm labor and adverse neonatal outcome. We evaluated amniotic fluid (AF) proteolytic cascade forming biomarkers in relation to microbial invasion of the amniotic cavity (MIAC) and IAI in preterm pregnancies with intact membranes. Material and Methods. Amniocentesis was made to 73 women with singleton pregnancies; 27 with suspected IAI; and 46 controls. AF biomarkers were divided into three cascades: Cascade 1: matrix metalloproteinase-8 (MMP-8), MMP-9, myeloperoxidase (MPO), and interleukin-6; Cascade 2: neutrophil elastase (HNE), elafn, and MMP-9; Cascade 3: MMP-2, tissue inhibitor of matrix  etalloproteinases-1 (TIMP-1), MMP-8/TIMP-1 molar ratio, and Creactive protein(CRP). MMP-8 was measured by an immunoenzymometric assay and the others were measured by ELISA. Standard biochemical methods, molecular microbiology, and culture techniques were used. Results. MMP-8, MMP-9, MPO, elafn, and TIMP-1 concentrations were higher in IAI suspected cases compared to controls and also in IAI suspected cases with MIAC compared to those without MIAC when adjusted by gestational age at amniocentesis. All biomarkers except elafn and MMP-2 had the sensitivity of 100% with thresholds based on ROC-curve. Odd ratios of biomarkers for MIAC were 1.2-38 and 95% confdential intervals 1.0-353.6. Conclusions. Neutrophil based AF biomarkers were associated with IAI and MIAC.

INTRODUCTION

Intra-amniotic infection (IAI), defned as microbial invasion of the amniotic cavity (MIAC) with intra-amniotic inflammation, is common in women with preterm labor and exists with or without preterm prelabor rupture of membranes (PPROM) . MIAC ofen leads to IAI . However, intraamniotic inflammation in the absence of MIAC also  occurs . Amniocentesis and amniotic fluid (AF) rapid biomarker testing may help in optimal timing of delivery. Infection may induce the degranulation of interleukin- (IL-) 6 and matrix metalloproteinases (MMP), from polymorphonuclear neutrophils (PMNs) . MMP-8 has been linked to MIAC , inflammation , histological chorioamnionitis (HCA), and adverse neonatal outcome .

Year: ۲۰۱۸

Publisher : HINDAWI

 By : Tarja Myntti, Leena Rahkonen,Irmeli Nupponen, Anu Pätäri-Sampo,Minna Tikkanen, Timo Sorsa, Juuso Juhila, Sture Andersson,Jorma Paavonen, and Vedran Stefanovic 

File Information: English Language/ 10 Page / size: 1.29 MB

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سال : ۱۳۹۶

ناشر : HINDAWI

کاری از : Tarja Myntti, Leena Rahkonen, Irmeli Nupponen, Anu Pätäri-Sampo, Minna Tikkanen, Timo Sorsa, Juos Juhila, Sture Andersson, Jorma Paavonen, and Vedran Stefanovic

اطلاعات فایل : زبان انگلیسی / 10 صفحه / حجم : MB 1.29

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