Elevated mid-trimester amniotic fluid ADAM-8 concentrations as a potential risk factor for preterm delivery

Area of Science:

• Reproductive Biology
• Maternal-Fetal Medicine
• Biochemistry

Background:

• Spontaneous preterm delivery remains a leading cause of neonatal morbidity and mortality.
• Identifying reliable biomarkers for preterm delivery risk is crucial for timely intervention.

Purpose of the Study:

• To investigate whether elevated amniotic fluid concentrations of A Disintegrin And Metalloprotease 8 (ADAM-8) and/or cortisol during mid-trimester amniocentesis can identify women at risk for spontaneous preterm delivery.

Main Methods:

• A cohort of 312 women undergoing mid-trimester amniocentesis was studied.
• Thirteen women who delivered preterm were matched with 21 controls.
• Amniotic fluid ADAM-8 and cortisol levels were quantified using enzyme-linked immunosorbent assay and radioimmunoassay, respectively.

Main Results:

• Significantly higher mean amniotic fluid ADAM-8 concentrations were observed in women who delivered preterm compared to those delivering at term (P < .02).
• ADAM-8 levels exceeding 1149 pg/mL demonstrated high specificity (81.7%) and an odds ratio of 9.6 for predicting preterm delivery risk.
• Cortisol levels were suggestively higher in the preterm delivery group and positively correlated with ADAM-8 levels (Spearman's r = .418, P < .014).

Conclusions:

• Elevated mid-trimester amniotic fluid ADAM-8 concentrations may serve as a potential risk factor for spontaneous preterm delivery.
• A threshold of 1149 pg/mL for ADAM-8 appears particularly indicative of increased preterm delivery risk.
• Suggestively elevated amniotic fluid cortisol levels may be associated with intrauterine inflammation in the context of preterm delivery risk.