Elevated second trimester amniotic fluid interferon gamma-inducible T-cell alpha chemoattractant concentrations as a possible predictor of preterm birth.
OBJECTIVE
To determine and correlate midtrimester amniotic fluid concentrations of interferon gamma-inducible T-cell alpha chemoattractant (ITAC, a chemokine directing the migration of activated T lymphocytes toward inflammation sites) and C-reactive protein (CRP) in women undergoing amniocentesis and subsequently delivering pre-or full-term infants.


METHODS
Among 312 women undergoing midtrimester transabdominal amniocentesis, 13 progressed to spontaneous delivery at less than 37 gestational weeks (GW). Subjects were matched for maternal age, parity, and GW at amniocentesis with 21 controls who delivered at greater than 37 GW. Amniotic fluid ITAC and CRP levels were determined by enzyme-linked immunosorbent assay (ELISA) and by nephelometry, respectively.


RESULTS
Both ITAC and CRP values were significantly higher (P = .005 and P = .04, respectively) in the amniotic fluid of women delivering at less than 37 GW. A statistically significant correlation between amniotic fluid ITAC and CRP concentrations was also found (r = .366, P < .05). The receiver operator curve (ROC) analysis of delivery at less than 37 GW gave the best cutoff point for ITAC at a concentration of 44 pg/mL and for CRP at a concentration of 0.16 mg/dL. Positive and negative predictive values for ITAC were 82% and 85%, respectively, and for CRP, 55% and 76%, respectively.


CONCLUSIONS
Present data indicate that from the second trimester of pregnancy elevated amniotic fluid concentrations of ITAC are found in women delivering at less than 37 GW, as compared to women delivering at term. Therefore, ITAC in combination with other cytokines or CRP could possibly serve as predictor of preterm delivery.
Malamitsi-Puchner
Ariadne
A
University of Athens, Medical School, Athens, Greece. malamitsi@acn.gr
Vrachnis
Nikolaos
N
Samoli
Evi
E
Baka
Stavroula
S
Hassiakos
Demetrios
D
Creatsas
George
G
D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D054371:Chemokine CXCL11; D019743:Chemokines, CXC / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth
C515202:CXCL11 protein, human; D054371:Chemokine CXCL11; D019743:Chemokines, CXC; D002097:C-Reactive Protein