Amniotic Fluid Infection in Preterm Pregnancies with Intact Membranes

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Tarja Myntti1, Leena Rahkonen1, Irmeli Nupponen2

  • 1Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Disease Markers
|February 8, 2017
PubMed

Insights

Neutrophil-based biomarkers in amniotic fluid show high sensitivity for detecting intra-amniotic infection (IAI) and microbial invasion of the amniotic cavity (MIAC) in preterm pregnancies. These findings aid in diagnosing IAI and MIAC, improving neonatal outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Infectious Diseases

Background:

  • Intra-amniotic infection (IAI) is a significant cause of preterm labor and poor neonatal outcomes.
  • Identifying IAI and microbial invasion of the amniotic cavity (MIAC) in preterm pregnancies is crucial for timely intervention.

Purpose of the Study:

  • To evaluate amniotic fluid (AF) proteolytic cascade biomarkers for their association with MIAC and IAI in preterm pregnancies with intact membranes.
  • To assess the diagnostic potential of specific AF biomarkers in relation to infection and microbial presence.

Main Methods:

  • Amniotic fluid samples were collected from 73 women with singleton pregnancies (27 suspected IAI, 46 controls).
  • Biomarkers from three proteolytic cascades (including MMP-8, MMP-9, MPO, HNE, elafin, TIMP-1, CRP) were measured using immunoassays and ELISA.
  • Microbiological methods were used to detect MIAC.

Main Results:

  • Elevated concentrations of MMP-8, MMP-9, MPO, elafin, and TIMP-1 were observed in IAI-suspected cases and in cases with MIAC.
  • Most biomarkers demonstrated 100% sensitivity for detecting IAI/MIAC based on ROC curve analysis.
  • Biomarkers showed significant odd ratios for MIAC, indicating their predictive value.

Conclusions:

  • Neutrophil-derived amniotic fluid biomarkers are strongly associated with IAI and MIAC in preterm pregnancies.
  • These biomarkers hold promise for the early diagnosis and management of intra-amniotic infections.
  • Further research can refine the use of these biomarkers for improved neonatal care.

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