Performance characteristics of putative tests for subclinical chorioamnionitis.
OBJECTIVE
To evaluate amniotic fluid glucose, matrix metalloproteinase (MMP)-9, interleukin (IL)-6, and IL-12 for diagnosing subclinical chorioamnionitis in women with preterm labor.


METHODS
Forty-four women in preterm labor at 22-35 weeks gestation with suspected subclinical chorioamnionitis underwent amniocentesis. Amniotic fluid analysis included Gram stain, culture, and determination of glucose, MMP-9, IL-6, and IL-12 concentrations. Median values of these analytes were compared using the Mann-Whitney U test. Sensitivity, specificity, and positive and negative predictive values were calculated for tests using a positive amniotic fluid culture or delivery within 24 hours as the key outcome variables.


RESULTS
Amniotic fluid concentrations of glucose, MMP-9, and IL-6 correlated closely with positive culture or delivery within 24 hours. IL- 12 concentrations did not correlate with either a positive culture or delivery within 24 hours.


CONCLUSIONS
Amniotic fluid glucose, MMP-9, and IL-6 reliably predict microbial invasion of the amniotic cavity or imminent delivery. IL- 12 values did not correlate with amniotic fluid culture results or imminent delivery.
Edwards
R K
RK
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville 32610-0294, USA.
Clark
P
P
Locksmith Gregory
J
J
Duff
P
P
D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D005260:Female; D005947:Glucose / Q000032:analysis / Q000096:biosynthesis; D006801:Humans; D018664:Interleukin-12 / Q000032:analysis / Q000096:biosynthesis; D015850:Interleukin-6 / Q000032:analysis / Q000096:biosynthesis; D020780:Matrix Metalloproteinase 9 / Q000032:analysis / Q000096:biosynthesis; D007752:Obstetric Labor, Premature / Q000382:microbiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D015850:Interleukin-6; D018664:Interleukin-12; D020780:Matrix Metalloproteinase 9; D005947:Glucose