Predictive value of combined amniotic fluid proteomic biomarkers and interleukin-6 in preterm labor with intact membranes.
OBJECTIVE
To assess proteomic biomarkers and interleukin-6 alone or in combination to predict intraamniotic infection, preterm birth, and neonatal morbidity in preterm labor with intact membranes.


METHODS
Amniotic fluid interleukin-6 and selected proteomic biomarkers were assayed from 86 patients with preterm labor and intact membranes (22-36 weeks). The predictive value of each marker alone or in combination was evaluated for intraamniotic infection, preterm birth, and neonatal composite morbidity.


RESULTS
Both interleukin-6 (odds ratio, 19.5; P = .012) and proteomic biomarkers (odds ratio, 25.2; P = .001) were statistically independent predictors of intraamniotic infection with sensitivity, positive predictive value, and false-positive rates of 25%, 17.6%, and 20% when 1 marker was present and of 75%, 75%, and 4.3% when both were detected. Their combination did not improve prediction of preterm birth or neonatal morbidity.


CONCLUSIONS
The combined use of proteomic biomarkers and interleukin-6 to predict intraamniotic infection shows better accuracy than when used alone.
Department of Maternal-Fetal Medicine, Institut de Investigacions Biomèdiques August Pi-Sunyer, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Teresa
T
Cobo
Montse
M
Palacio
Aleix
A
Navarro-Sastre
Antonia
A
Ribes
Jordi
J
Bosch
Xavier
X
Filella
Eduard
E
Gratacós
D000328:Adult; D000650:Amnion; D000653:Amniotic Fluid / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000378:metabolism*; D016015:Logistic Models; D009017:Morbidity; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D011446:Prospective Studies; D040901:Proteomics; D012680:Sensitivity and Specificity; D055815:Young Adult
D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6