Clinical and inflammatory markers in amniotic fluid as predictors of adverse outcomes in preterm premature rupture of membranes

Am J Obstet Gynecol. 2011 Aug;205(2):126.e1-8. doi: 10.1016/j.ajog.2011.03.050. Epub 2011 Apr 8.

Abstract

Objective: We sought to evaluate gestational age, cervical length, amniotic fluid interleukin (IL)-6, and selected proteomic biomarkers as independent predictors of adverse outcome in preterm premature rupture of membranes (PPROM).

Study design: This was a prospective cohort study of 65 consecutive women with PPROM (20.0-34.6 weeks). Gestational age, cervical length, amniotic fluid IL-6, and proteomic biomarkers (calgranulins A and C, and neutrophil defensins 1 and 2) were evaluated at diagnosis. The predictive value for intraamniotic infection and neonatal composite morbidity was calculated by logistic regression.

Results: Proteomic biomarkers were independent predictors of intraamniotic infection (odds ratio, 22.1; P=.011) and neonatal composite morbidity (odds ratio, 17.6; P=.02). With the exception of a trend between gestational age and neonatal morbidity (P=.054), none of the other parameters were independent predictors of outcome measures.

Conclusion: Selected proteomic biomarkers were the only independent predictors of adverse outcomes in PPROM. Contrary to what is reported in preterm labor with intact membranes, gestational age, cervical length, and IL-6 were not.

MeSH terms

  • Adult
  • Amniotic Fluid / chemistry
  • Amniotic Fluid / metabolism*
  • Biomarkers / analysis*
  • Biomarkers / metabolism
  • Cohort Studies
  • Female
  • Fetal Membranes, Premature Rupture / diagnosis*
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Inflammation Mediators / analysis*
  • Inflammation Mediators / metabolism
  • Interleukin-6 / analysis
  • Interleukin-6 / metabolism
  • Obstetric Labor, Premature / diagnosis*
  • Parity
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome
  • Prospective Studies
  • Risk Assessment
  • Time Factors
  • Young Adult

Substances

  • Biomarkers
  • Inflammation Mediators
  • Interleukin-6