Amniotic fluid matrix metalloproteinase-8 indicates intra-amniotic infection.
OBJECTIVE
This study was undertaken to determine whether matrix metalloproteinase-8, which is produced by neutrophils, is a useful marker for the detection of intra-amniotic infection.


METHODS
We performed a case-control study using enzyme-linked immunosorbent assays to detect matrix metalloproteinase-8 in 77 amniotic fluid specimens that were obtained by amniocentesis from women with preterm contractions or preterm labor and intact fetal membranes (n = 66) and from women with preterm premature rupture of membranes (n = 11).


RESULTS
Thirty women had culture-proven intra-amniotic infection (cases), 21 of whom had intact membranes. After constructing receiver operating characteristic curves to establish the optimal threshold concentration of matrix metalloproteinase-8 for a positive test result, we detected matrix metalloproteinase-8 in 27 of 30 women with intra-amniotic infection; only 10 of 47 control specimens contained matrix metalloproteinase-8 (P <.001; odds ratio, 33.3; 95% CI, 8.4, 132.7). Matrix metalloproteinase-8 was present in 20 of 21 women with intact membranes and intra-amniotic infection and in only 10 of 45 control subjects (P <.001; odds ratio, 70.0; 95% CI, 8.3, 587.6). Among women with intact membranes, the sensitivity of the assay was 0.95 and the specificity was 0.78.


CONCLUSIONS
Our results indicate that matrix metalloproteinase-8 is highly correlated with intra-amniotic infection and that enzyme-linked immunosorbent assay for matrix metalloproteinase-8 may be a clinically useful test for the diagnosis of intra-amniotic infection in women with preterm contractions and preterm labor.
Angus
S R
SR
Center for Research on Reproduction and Women's Health, University of Pennsylvania, Philadelphia 19104-6142, USA.
Segel
S Y
SY
Hsu
C D
CD
Locksmith
G J
GJ
Clark
P
P
Sammel
M D
MD
Macones
G A
GA
Strauss
J F
JF
Parry
S
S
D000650:Amnion / Q000382:microbiology*; D000653:Amniotic Fluid / Q000201:enzymology*; D015415:Biomarkers; D016022:Case-Control Studies; D005321:Extraembryonic Membranes / Q000502:physiology; D005260:Female; D006801:Humans; D007239:Infections / Q000201:enzymology*; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism*; D007752:Obstetric Labor, Premature / Q000201:enzymology / Q000382:microbiology; D011247:Pregnancy; D012016:Reference Values; D012680:Sensitivity and Specificity
D015415:Biomarkers; D020784:Matrix Metalloproteinase 8