title: Amniotic fluid concentrations of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 during pregnancy and labor.
abstract: OBJECTIVE
  This study was undertaken to determine whether obstetric factors affect the concentrations of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 in the amniotic fluid.
  
  
  METHODS
  We prospectively collected amniotic fluid samples from 109 women at various stages of pregnancy and labor and determined matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 concentrations by means of enzyme-linked immunosorbent sandwich assay systems. With multiple regression analysis we evaluated relationships between amniotic fluid matrix metalloproteinase 9 concentration and tissue inhibitor of metalloproteinase 1 concentration and the following factors: gestational age, presence of labor, cervical dilatation, membrane status, presence of clinical chorioamnionitis, and microbial colonization of the amniotic fluid.
  
  
  RESULTS
  The detectable presence of amniotic fluid matrix metalloproteinase 9 was independently associated with intra-amniotic infection, labor, cervical dilatation, and spontaneous rupture of membranes. Chorioamnionitis and amniotic fluid matrix metalloproteinase 9 concentrations were correlated with tissue inhibitor of metalloproteinase 1 levels.
  
  
  CONCLUSIONS
  Intra-amniotic infection, advanced labor, and rupture of membranes before the onset of labor were independently associated with the presence of matrix metalloproteinase 9 in the amniotic fluid. Both pathologic and physiologic processes appear to produce shifts in the balance between degradation and synthesis of the extracellular matrix.
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainsville, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Locksmith
authors.forename: P
authors.initials: P
authors.lastname: Clark
authors.forename: P
authors.initials: P
authors.lastname: Duff
authors.forename: G R
authors.initials: GR
authors.lastname: Saade
authors.forename: G S
authors.initials: GS
authors.lastname: Schultz
mesh_terms: D000653:Amniotic Fluid / Q000201:enzymology*; D002821:Chorioamnionitis / Q000201:enzymology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007747:Labor Stage, First / Q000378:metabolism; D007743:Labor, Obstetric / Q000378:metabolism*; D020780:Matrix Metalloproteinase 9 / Q000032:analysis*; D011247:Pregnancy; D011446:Prospective Studies; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000032:analysis*
chemical_list: D019715:Tissue Inhibitor of Metalloproteinase-1; D020780:Matrix Metalloproteinase 9