title: Adiponectin in amniotic fluid in normal pregnancy, spontaneous labor at term, and preterm labor: a novel association with intra-amniotic infection/inflammation.
abstract: OBJECTIVE
  Adiponectin, an anti-inflammatory and anti-diabetogenic adipokine, has an important regulatory effect on both the innate and adaptive limbs of the immune response. The objective of this study was to determine whether adiponectin is present in amniotic fluid (AF) and if its concentration changes with gestational age, in the presence of labor, and in the presence of intra-amniotic infection (IAI) in patients with spontaneous preterm labor (PTL) and intact membranes.
  
  
  METHODS
  This cross-sectional study included 468 patients in the following groups: (1) women in the mid-trimester of pregnancy (14-18 weeks) who underwent amniocentesis for genetic indications and delivered a normal neonate at term (n = 52); (2) normal pregnant women at term with (n = 49) and without (n = 41) spontaneous labor; (3) patients with an episode of PTL and intact membranes who were classified into: (a) PTL who delivered at term (n = 149); (b) PTL who delivered preterm (<37 weeks gestation) without IAI (n = 108); and (c) PTL with IAI (n = 69). Adiponectin concentration in AF was determined by ELISA.
  
  
  RESULTS
  (1) The median AF adiponectin concentration at term was significantly higher than in the mid-trimester (35.6 ng/ml, interquartile range [IQR] 26.4-52.7 vs. 29.9 ng/ml, IQR 19.9-35.2; p = 0.01); (2) among women with PTL and intact membranes, the median AF adiponectin concentration was significantly higher in patients with IAI than in those without IAI who delivered either at term (54.3 ng/ml, 39.0-91.8 vs. 50.1 ng/ml, 33.2-72.8; p = 0.02) or preterm (47.6 ng/ml, 32.6-74.6; p = 0.01); and (3) among women at term, there was no significant difference in the median AF adiponectin concentration between those with and without labor (33.7 ng/ml, IQR 21.7-53.9 vs. 35.6 ng/ml, IQR 26.4-52.7; respectively p = 0.5).
  
  
  CONCLUSIONS
  (1) Adiponectin is a physiologic constituent of AF; and (2) adiponectin concentrations in AF are increased significantly with advancing gestation and in the presence of IAI. Collectively, these findings suggest that adiponectin plays a dynamic role in normal gestation and in the presence of IAI.
authors: Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, Maryland, USA.
authors: Shali
authors: S
authors: Mazaki-Tovi
authors: Roberto
authors: R
authors: Romero
authors: Edi
authors: E
authors: Vaisbuch
authors: Juan Pedro
authors: JP
authors: Kusanovic
authors: Offer
authors: O
authors: Erez
authors: Pooja
authors: P
authors: Mittal
authors: Francesca
authors: F
authors: Gotsch
authors: Tinnakorn
authors: T
authors: Chaiworapongsa
authors: Nandor Gabor
authors: NG
authors: Than
authors: Sun Kwon
authors: SK
authors: Kim
authors: Percy
authors: P
authors: Pacora
authors: Lami
authors: L
authors: Yeo
authors: Zhong
authors: Z
authors: Dong
authors: Sonia S
authors: SS
authors: Hassan
mesh_terms: D052242:Adiponectin / Q000032:analysis*; D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D002821:Chorioamnionitis / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007743:Labor, Obstetric / Q000378:metabolism*; D007752:Obstetric Labor, Premature / Q000378:metabolism*; D011247:Pregnancy
chemical_list: D052242:Adiponectin