Inflammatory proteins in maternal plasma, cervicovaginal and amniotic fluids as predictors of intra-amniotic infection in preterm premature rupture of membranes

• Published in: PloS one Vol. 13; no. 7; p. e0200311
• Main Authors: Lee, Seung Mi, Park, Kyo Hoon, Jung, Eun Young, Kook, Song Yi, Park, Hyunsoo, Jeon, Se Jeong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06-07-2018; Public Library of Science (PLoS)
• Subjects: Adult; Amniocentesis; Amniotic fluid; Amniotic Fluid - metabolism; Amniotic Fluid - microbiology; Biology and Life Sciences; Biomarkers; Chorioamnionitis - diagnosis; Chorioamnionitis - metabolism; Chorioamnionitis - microbiology; Computational fluid dynamics; Correlation; Cytokines; Cytokines - blood; Cytokines - metabolism; Female; Fetal Membranes, Premature Rupture - diagnosis; Fetal Membranes, Premature Rupture - metabolism; Fetal Membranes, Premature Rupture - microbiology; Fluid; Fluids; Gynecology; Health aspects; Humans; Immunoassay; Infections; Inflammation; Interleukin; Interleukin 6; Interleukin 8; Macrophage inflammatory protein; Medicine; Medicine and Health Sciences; Membranes; Microorganisms; Monocyte chemoattractant protein 1; Monocytes; Mycoplasma - isolation & purification; Mycoplasma Infections - diagnosis; Mycoplasma Infections - metabolism; Mycoplasma Infections - microbiology; Obstetrics; Placenta; Plasma; Prediction models; Pregnancy; Premature rupture of the membrane; Prognosis; Proteins; Regression analysis; Regression models; Retrospective Studies; Rupture; Rupturing; Ultrasonic imaging; Ureaplasma - isolation & purification; Ureaplasma Infections - diagnosis; Ureaplasma Infections - metabolism; Ureaplasma Infections - microbiology; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0200311

We aimed to assess the correlations among multiple cytokine concentrations in the maternal plasma, cervicovaginal fluid (CVF), and amniotic fluid (AF) compartments in women with preterm premature rupture of membranes (pPROM), and to develop a prediction model based on non-invasive measures, having better sensitivity and specificity for the identification of microbial invasion of amniotic cavity (MIAC).
This retrospective study included 75 consecutive women with pPROM (20+0-34+0 weeks), who underwent amniocentesis. Both maternal plasma and CVF samples were collected at the time of amniocentesis. Stored AF, plasma and CVF samples were assayed for cytokine levels [interleukin (IL)-6, IL-8, monocyte chemotactic protein-1, macrophage inflammatory protein (MIP)-1α, MIP-1β] using a multiplex immunoassay kit.
Levels of inflammatory proteins measured in the CVF were significantly correlated with AF proteins levels, whereas none of the proteins in plasma correlated significantly with any in the AF or CVF. Proteins levels measured in the AF and CVF were significantly higher in women with MIAC compared to those without, whereas only high levels of IL-6 in plasma were significantly associated with MIAC. By using stepwise regression analysis, a non-invasive model (using clinical factors and CVF cytokine levels) for the prediction of MIAC was developed; the area under curve of this non-invasive model was similar to that of the invasive model (using clinical factors and AF cytokines).
The levels of inflammatory proteins in the CVF correlated with those in the AF, whereas those in the plasma showed no correlation. A non-invasive model using clinical factors and CVF cytokine levels predicted the risk of MIAC in women with pPROM.