[Concentration of the soluble molecule ICAM-1 (sICAM-1) in the amniotic fluid as the marker of the intrauterine infection at pregnant women and at newborns].
THE AIM of this study was to evaluate the usefulness of determining concentrations of sICAM-1 in amniotic fluid as an indicator of intrauterine infection in pregnant women and infants.


METHODS
the study was conducted on a group of 60 pregnant women by taking samples of amniotic fluid during delivery. Thirty of the women in the group had normal delivery and 30 had Caesarean section. The women were divided into three subgroups: 1) with (n-30) or without (n-30) symptoms of infection in the infant; with (n-21) or without (n-39) symptoms of intrauterine infection in the pregnant woman; with (n-14) or without (n-23) symptoms of simultaneous infection in both mother and child; with premature termination of pregnancy (n-17) or term delivery (n-43). Concentrations of sICAM-1 were determined by ELISA method using monoclonal antibodies specific for sICAM-1, and the use of Quantikine kit from the firm RD Systems Europe Ltd. Statistical analysis was conducted using the U Mann-Whitney test, chi square and ROC (Receiver Operating Characteristic) curve. LR (likelihood ratio) was also determined.


RESULTS
statistically significantly higher concentrations of sICAM were detected in the amniotic fluid of the group of mothers with intrauterine infection, symptoms of simultaneous infection in both mother and child and in the group with premature pregnancy termination - respectively p<0.02; p<0.001; and p<0.0001. ROC analysis, taking into account infection in infants (AUC- 0.623) allowed the determination of a cut off value of sICAM concentration in amniotic fluid of 422 ng/ml. That value is clinically useful for confirming intrauterine origins of symptoms of infection in pregnant women (sensitivity - 52.9%, specificity - 86.8%, LR - 5.03). It might also be useful in predicting infection in infants born of women who showed symptoms of infection before delivery (sensitivity - 72.7%, specificity - 95.7%, LR - 16.73).


CONCLUSIONS
1. Clinical symptoms of intrauterine infection in pregnant women, simultaneous infection in both mother and child and premature pregnancy termination are correlated with significant increase of sICAM concentrations in the amniotic fluid. 2. An increase of sICAM concentration in the amniotic fluid >422 ng/ml allows confirmation of intrauterine origin of infection symptoms in pregnant women and allows the prediction of infection in infants born of women who showed symptoms of infection.
Plonka
Tomasz
T
Klinika Medycyny Matczyno-Płodowej, Pomorska Akademia Medyczna, ul. Unii Lubelskiej 1, Szczecin, Poland. tomp71@o2.pl
Bilar
Marek
M
Sipak-Szmigiel
Olimpia
O
Ronin-Walknowska
Elzbieta
E
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D015415:Biomarkers; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005865:Gestational Age; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis*; D007752:Obstetric Labor, Premature / Q000382:microbiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011256:Pregnancy Outcome; D012680:Sensitivity and Specificity
D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1