Cargando…

Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study

BACKGROUND: We investigated whether various inflammatory and immune proteins in plasma predict intra-amniotic infection and imminent preterm delivery in women with preterm labor and compared their predictive ability with that of amniotic fluid (AF) interleukin (IL)-6 and serum C-reactive protein (CR...

Descripción completa

Detalles Bibliográficos
Autores principales: Park, Hyunsoo, Park, Kyo Hoon, Kim, Yu Mi, Kook, Song Yi, Jeon, Se Jeong, Yoo, Ha-Na
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944139/
https://www.ncbi.nlm.nih.gov/pubmed/29743041
http://dx.doi.org/10.1186/s12884-018-1780-7
_version_ 1783321770092134400
author Park, Hyunsoo
Park, Kyo Hoon
Kim, Yu Mi
Kook, Song Yi
Jeon, Se Jeong
Yoo, Ha-Na
author_facet Park, Hyunsoo
Park, Kyo Hoon
Kim, Yu Mi
Kook, Song Yi
Jeon, Se Jeong
Yoo, Ha-Na
author_sort Park, Hyunsoo
collection PubMed
description BACKGROUND: We investigated whether various inflammatory and immune proteins in plasma predict intra-amniotic infection and imminent preterm delivery in women with preterm labor and compared their predictive ability with that of amniotic fluid (AF) interleukin (IL)-6 and serum C-reactive protein (CRP). METHODS: This retrospective cohort study included 173 consecutive women with preterm labor who underwent amniocentesis for diagnosis of infection and/or inflammation in the AF. The AF was cultured, and assayed for IL-6. CRP levels and cervical length by transvaginal ultrasound were measured at the time of amniocentesis. The stored maternal plasma was assayed for IL-6, matrix metalloproteinase (MMP)-9, and complements C3a and C5a using ELISA kits. The primary and secondary outcome criteria were positive AF cultures and spontaneous preterm delivery (SPTD) within 48 h, respectively. Univariate, multivariate, and receiver operating characteristic analysis were used for the statistical analysis. RESULTS: In bivariate analyses, elevated plasma IL-6 level was significantly associated with intra-amniotic infection and imminent preterm delivery, whereas elevated plasma levels of MMP-9, C3a, and C5a were not associated with these two outcomes. On multivariate analyses, an elevated plasma IL-6 level was significantly associated with intra-amniotic infection and imminent preterm delivery after adjusting for confounders, including high serum CRP levels and short cervical length. In predicting intra-amniotic infection, the area under the curve (AUC) was significantly lower for plasma IL-6 than for AF IL-6 but was similar to that for serum CRP. Differences in the AUCs between plasma IL-6, AF IL-6, and serum CRP were not statistically significant in predicting imminent preterm delivery. CONCLUSIONS: Maternal plasma IL-6 independently predicts intra-amniotic infection in women with preterm labor; however, it has worse diagnostic performance than that of AF IL-6 and similar performance to that of serum CRP. To predict imminent preterm delivery, plasma IL-6 had an overall diagnostic performance similar to that of AF IL-6 and serum CRP. Plasma MMP-9, C3a, and C5a levels could not predict intra-amniotic infection or imminent preterm delivery.
format Online
Article
Text
id pubmed-5944139
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-59441392018-05-14 Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study Park, Hyunsoo Park, Kyo Hoon Kim, Yu Mi Kook, Song Yi Jeon, Se Jeong Yoo, Ha-Na BMC Pregnancy Childbirth Research Article BACKGROUND: We investigated whether various inflammatory and immune proteins in plasma predict intra-amniotic infection and imminent preterm delivery in women with preterm labor and compared their predictive ability with that of amniotic fluid (AF) interleukin (IL)-6 and serum C-reactive protein (CRP). METHODS: This retrospective cohort study included 173 consecutive women with preterm labor who underwent amniocentesis for diagnosis of infection and/or inflammation in the AF. The AF was cultured, and assayed for IL-6. CRP levels and cervical length by transvaginal ultrasound were measured at the time of amniocentesis. The stored maternal plasma was assayed for IL-6, matrix metalloproteinase (MMP)-9, and complements C3a and C5a using ELISA kits. The primary and secondary outcome criteria were positive AF cultures and spontaneous preterm delivery (SPTD) within 48 h, respectively. Univariate, multivariate, and receiver operating characteristic analysis were used for the statistical analysis. RESULTS: In bivariate analyses, elevated plasma IL-6 level was significantly associated with intra-amniotic infection and imminent preterm delivery, whereas elevated plasma levels of MMP-9, C3a, and C5a were not associated with these two outcomes. On multivariate analyses, an elevated plasma IL-6 level was significantly associated with intra-amniotic infection and imminent preterm delivery after adjusting for confounders, including high serum CRP levels and short cervical length. In predicting intra-amniotic infection, the area under the curve (AUC) was significantly lower for plasma IL-6 than for AF IL-6 but was similar to that for serum CRP. Differences in the AUCs between plasma IL-6, AF IL-6, and serum CRP were not statistically significant in predicting imminent preterm delivery. CONCLUSIONS: Maternal plasma IL-6 independently predicts intra-amniotic infection in women with preterm labor; however, it has worse diagnostic performance than that of AF IL-6 and similar performance to that of serum CRP. To predict imminent preterm delivery, plasma IL-6 had an overall diagnostic performance similar to that of AF IL-6 and serum CRP. Plasma MMP-9, C3a, and C5a levels could not predict intra-amniotic infection or imminent preterm delivery. BioMed Central 2018-05-09 /pmc/articles/PMC5944139/ /pubmed/29743041 http://dx.doi.org/10.1186/s12884-018-1780-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Park, Hyunsoo
Park, Kyo Hoon
Kim, Yu Mi
Kook, Song Yi
Jeon, Se Jeong
Yoo, Ha-Na
Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study
title Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study
title_full Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study
title_fullStr Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study
title_full_unstemmed Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study
title_short Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study
title_sort plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944139/
https://www.ncbi.nlm.nih.gov/pubmed/29743041
http://dx.doi.org/10.1186/s12884-018-1780-7
work_keys_str_mv AT parkhyunsoo plasmainflammatoryandimmuneproteinsaspredictorsofintraamnioticinfectionandspontaneouspretermdeliveryinwomenwithpretermlaboraretrospectivestudy
AT parkkyohoon plasmainflammatoryandimmuneproteinsaspredictorsofintraamnioticinfectionandspontaneouspretermdeliveryinwomenwithpretermlaboraretrospectivestudy
AT kimyumi plasmainflammatoryandimmuneproteinsaspredictorsofintraamnioticinfectionandspontaneouspretermdeliveryinwomenwithpretermlaboraretrospectivestudy
AT kooksongyi plasmainflammatoryandimmuneproteinsaspredictorsofintraamnioticinfectionandspontaneouspretermdeliveryinwomenwithpretermlaboraretrospectivestudy
AT jeonsejeong plasmainflammatoryandimmuneproteinsaspredictorsofintraamnioticinfectionandspontaneouspretermdeliveryinwomenwithpretermlaboraretrospectivestudy
AT yoohana plasmainflammatoryandimmuneproteinsaspredictorsofintraamnioticinfectionandspontaneouspretermdeliveryinwomenwithpretermlaboraretrospectivestudy