title: Monocyte chemotactic protein-1 is increased in the amniotic fluid of women who deliver preterm in the presence or absence of intra-amniotic infection.
abstract: OBJECTIVE
  Pro-inflammatory chemokines have been associated with preterm parturition. Monocyte chemotactic protein-1 (MCP-1) is a chemokine capable of recruiting monocytes/macrophages into sites of inflammation, as well as stimulating the respiratory burst required for macrophage activation. MCP-1 transcripts and immuno-reactivity are expressed by uterine tissues (i.e., decidual cells and myometrium) and, thus, may participate in the process of labor. This study was conducted to determine if preterm labor leading to preterm delivery and intra-amniotic infection (IAI) are associated with changes in the amniotic fluid concentrations of MCP-1.
  
  
  METHODS
  A cross-sectional study was designed to examine the amniotic fluid concentrations of MCP-1 in women in two groups: 1) those presenting with preterm labor with intact membranes; and 2) those with preterm prelabor rupture of membranes (PROM). Amniotic fluid was obtained by transabdominal amniocentesis from 131 women in preterm labor with intact membranes and 105 women with preterm PROM. IAI was defined by a positive amniotic fluid culture for microorganisms. Group 1 included women with preterm labor and intact membranes (n=131), and was subdivided into the following groups: a) delivery at term in the absence of IAI (n=42); b) preterm delivery (< 37 weeks) in the absence of IAI (n=58); and c) preterm delivery in the presence of IAI (n=31). Group 2 consisted of women with PROM (n=105), and was subdivided into women with (n=51) and without (n=54) IAI. Non-parametric statistics were used for data analysis.
  
  
  RESULTS
  1) Immuno-reactive MCP-1 was detected in all amniotic fluid samples; 2) IAI, regardless of the membrane status, was associated with a significantly higher median amniotic fluid concentration of immuno-reactive MCP-1 than those without IAI (p<0.001 for both comparisons); 3) women in preterm labor who delivered preterm without IAI had a significantly higher median amniotic fluid concentration of immuno-reactive MCP-1 than those who delivered at term (p<0.001); 4) histological chorioamnionitis was associated with increased amniotic fluid concentrations of immuno-reactive MCP-1; and 5) a significant relationship existed between the amniotic fluid concentrations of immuno-reactive MCP-1 and the interval from amniocentesis to delivery.
  
  
  CONCLUSIONS
  Amniotic fluid concentrations of immuno-reactive MCP-1 were increased in women in preterm labor with IAI, those without IAI who delivered preterm, and those who displayed acute inflammatory lesions in the extra-placental membranes. These findings suggest that MCP-1 may play a role in preterm labor regardless of the presence of IAI.
authors: Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
authors: M Sean
authors: MS
authors: Esplin
authors: Roberto
authors: R
authors: Romero
authors: Tinnakorn
authors: T
authors: Chaiworapongsa
authors: Yeon Mee
authors: YM
authors: Kim
authors: Samuel
authors: S
authors: Edwin
authors: Ricardo
authors: R
authors: Gomez
authors: Moshe
authors: M
authors: Mazor
authors: Eli Y
authors: EY
authors: Adashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000649:Amniocentesis; D000650:Amnion; D000653:Amniotic Fluid / Q000737:chemistry* / Q000382:microbiology*; D018932:Chemokine CCL2 / Q000032:analysis*; D002821:Chorioamnionitis / Q000378:metabolism / Q000382:microbiology; D036861:Delivery, Obstetric; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D007239:Infections; D007752:Obstetric Labor, Premature / Q000378:metabolism*; D011247:Pregnancy; D013997:Time Factors
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2