The relationship between amniotic fluid matrix metalloproteinase-8 and funisitis

Area of Science:

• Perinatal Medicine
• Neonatology
• Biochemistry

Background:

• Fetal inflammatory response syndrome (FIRS) is linked to preterm birth and poor neonatal outcomes.
• Funisitis, umbilical cord inflammation, is a histological sign of FIRS and associated with cerebral palsy risk.
• Neutrophils in amniotic fluid are fetal in origin, making their products potential FIRS indicators.

Purpose of the Study:

• To investigate the association between amniotic fluid matrix metalloproteinase-8 (MMP-8) concentrations and the presence of funisitis.
• To evaluate MMP-8 as a potential biomarker for fetal inflammatory response syndrome.

Main Methods:

• Amniotic fluid MMP-8 levels were measured in 255 preterm neonates (<36 weeks) delivered within 72 hours of amniocentesis.
• Funisitis was diagnosed histologically by neutrophil infiltration in umbilical cord tissues.
• MMP-8 concentrations were quantified using a specific immunoassay; nonparametric statistics were employed.

Main Results:

• Funisitis was detected in 23% of cases.
• Amniotic fluid MMP-8 concentrations were significantly higher in neonates with funisitis (median 433.7 ng/mL) compared to those without (median 1.9 ng/mL; P <.001).
• MMP-8 demonstrated high sensitivity (90%) and negative predictive value (96%) for identifying funisitis at a cutoff of 23 ng/mL.

Conclusions:

• A strong association exists between elevated amniotic fluid MMP-8 levels and funisitis.
• Amniotic fluid MMP-8 measurement may serve as a valuable, non-invasive tool for assessing fetal inflammatory status.
• This biomarker could potentially obviate the need for fetal blood sampling in evaluating FIRS.