Serum intercellular adhesion molecule-1 levels and histologic chorioamnionitis.
OBJECTIVE
To compare the diagnostic value of intercellular adhesion molecule (ICAM)-1 with that of C-reactive protein (CRP) and white blood cell (WBC) count for detecting histologic chorioamnionitis in serum of women with preterm labor.


METHODS
Maternal blood was collected from 97 consecutive women admitted with preterm delivery before 37 weeks' gestation, and 50 women after normal term delivery (38-41 weeks' gestation). Intercellular adhesion molecule-1, CRP, and WBC count were measured before delivery.


RESULTS
Histologic chorioamnionitis was diagnosed in 48 of 97 women (48%) who delivered preterm and in none who delivered at term. Maternal serum levels of ICAM-1 (median 169 ng/mL, range 94-510 ng/mL, P <.001), CRP (median 2.8 ng/mL, range 0.5-13.2 mg/dL, P <.001) and WBC count (12.6 x 10(3)/microL, range 6.4-30.6 x 10(3)/microL, P <.02) were statistically significantly higher in women with histologic chorioamnionitis than those without it (ICAM-1 median 70 ng/mL, range 23-107 ng/mL; CRP median 0.7 mg/dL, range 0.5-6.7 mg/dL; WBC count median 10.9 x 10(3)/microL, range 4.3-22.2 x 10(3)/microL). The sensitivity and specificity of maternal serum ICAM-1 (cutoff 106 ng/mL), CRP (cutoff 1.1 mg/dL), and WBC count (cutoff 11.8 x 10(3)/microL) for diagnosing histologic chorioamnionitis were 98.0% and 93.8%, 75.5% and 71.4%, and 63.3% and 61.2%, respectively.


CONCLUSIONS
In women with preterm labor, ICAM-1 is a more reliable indicator of histologic chorioamnionitis than CRP or WBC count.
Steinborn
A
A
Department of Obstetrics and Gynecology, J.-W. Goethe-University of Frankfurt, Frankfurt/Main, Germany. Steinborn@em.uni-frankfurt.de
Sohn
C
C
Scharf
A
A
Geka
F
F
Heger
S
S
Kaufmann
M
M
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D007958:Leukocyte Count; D007752:Obstetric Labor, Premature / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D012680:Sensitivity and Specificity
D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein