Related Experiment Videos
Relationship between granulocyte elastase levels and perinatal infections
Y Matsuda1, H Maruyama, K Kuraya
1Department of Obstetrics and Gynecology, Kagoshima City Hospital, Japan.
Insights
Amniotic fluid granulocyte elastase (Af-E) effectively predicts neonatal infections. Cervical granulocyte elastase (Cx-E) and C-reactive protein (CRP) together help diagnose intrauterine infections before delivery.
Area of Science:
- Perinatal Medicine
- Infectious Diseases
- Biomarker Research
Background:
- Perinatal infections pose significant risks to mothers and newborns.
- Early detection of intrauterine infections is crucial for timely intervention.
- Granulocyte elastase and C-reactive protein are potential biomarkers for infection.
Purpose of the Study:
- To evaluate granulocyte elastase levels as predictors of perinatal infections.
- To compare the diagnostic efficacy of cervical (Cx-E), amniotic fluid (Af-E), and gastric juice (Gj-E) elastase, alongside C-reactive protein (CRP).
- To assess the correlation between elastase levels at different sites.
Main Methods:
- Prospective study of 41 patients delivering within 48 hours of amniocentesis.
- Measurement of Cx-E, serum CRP, and Af-E.
- Neonatal Gj-E measured in select cases.
- Comparative analysis of diagnostic efficacy for placental and neonatal infections, and abnormal amniotic fluid.
Main Results:
- Abnormal Af-E (0.79) and placental infections (0.97) showed superior diagnostic efficacy in predicting neonatal infections compared to Cx-E (0.40) and CRP (0.49).
- A strong correlation was observed between Af-E and Gj-E, but not between Cx-E and Af-E or Gj-E.
- Combined Cx-E and CRP levels demonstrated the highest diagnostic efficacy (0.58) for predicting abnormal amniotic fluid.
Conclusions:
- Af-E is a valuable biomarker for predicting neonatal infections.
- Elevated Cx-E and CRP levels may warrant amniocentesis for diagnosing intrauterine infections.
- Further investigation into elastase as a predictive marker in perinatal infections is supported.
Abstract:
This study was conducted in order to investigate the usefulness of granulocyte elastase levels as predictive factors in the onset of perinatal infections. The subjects were 41 patients who delivered within 48 h after amniocentesis after giving their informed consent. The relationship between cervical granulocyte elastase (Cx-E), serum C-reactive protein (CRP) and amniotic fluid granulocyte elastase (Af-E), and placental infections and neonatal infections was comparatively investigated. In some cases, gastric juice granulocyte elastase in neonates (Gj-E) was measured, and the correlation by site was investigated. Elastase levels were not used as a management protocol. In predicting neonatal infections, diagnostic efficacy (sensitivity x specificity) of placental infections (0.97) and abnormal Af-E (0.79) were superior to those of abnormal Cx-E (0.40) and abnormal CRP (0.49). There was no correlation between Cx-E and Af-E or between Cx-E and Gj-E; however, a very close correlation was noted between Af-E and Gj-E. In predicting abnormal amniotic fluids, Cx-E (> or = 1.2 micrograms/ml) + CRP (> or = 1.0 mg/dl) had the highest diagnostic efficacy with 0.58. These findings demonstrate that Af-E is a good index for predicting the onset of neonatal infections. In predicting abnormal amniotic fluid, it might be advisable to consider amniocentesis in order to diagnose intrauterine infections, when both Cx-E and CRP show abnormal levels.