title: Pentraxin 3 in maternal circulation: an association with preterm labor and preterm PROM, but not with intra-amniotic infection/inflammation.
abstract: OBJECTIVE
  Pentraxin 3 (PTX3) is an acute-phase protein that has an important role in the regulation of the innate immune response. The aim of this study was to determine if maternal plasma PTX3 concentration changes in the presence of intra-amniotic infection and/or inflammation (IAI) in women with preterm labor (PTL) and intact membranes, as well as those with preterm prelabor rupture of membranes (preterm PROM).
  
  
  METHODS
  This cross-sectional study included women in the following groups: (1) nonpregnant (n=40); (2) uncomplicated pregnancies in the first (n=22), second (n=22) or third trimester (n=71, including 50 women at term not in labor); (3) uncomplicated pregnancies at term with spontaneous labor (n=49); (4) PTL and intact membranes who delivered at term (n=49); (5) PTL without IAI who delivered preterm (n=26); (6) PTL with IAI (n=65); (7) preterm PROM without IAI (n=25); and (8) preterm PROM with IAI (n=77). Maternal plasma PTX3 concentrations were determined by ELISA.
  
  
  RESULTS
  (1) Maternal plasma PTX3 concentrations increased with advancing gestational age (r=0.62, p<0.001); (2) women at term with spontaneous labor had a higher median plasma PTX3 concentration than those at term not in labor (8.29 ng/ml vs. 5.98  ng/ml, p=0.013); (3) patients with an episode of PTL, regardless of the presence or absence of IAI and whether these patients delivered preterm or at term had a higher median plasma PTX3 concentration than normal pregnant women (p<0.001 for all comparisons); (4) similarly, patients with preterm PROM, with or without IAI had a higher median plasma PTX3 concentration than normal pregnant women (p<0.001 for both comparisons); and (5) among patients with PTL and those with preterm PROM, IAI was not associated with significant changes in the median maternal plasma PTX3 concentrations.
  
  
  CONCLUSIONS
  The maternal plasma PTX3 concentration increases with advancing gestational age and is significantly elevated during labor at term and in the presence of spontaneous preterm labor or preterm PROM. These findings could not be explained by the presence of IAI, suggesting that the increased PTX3 concentration is part of the physiologic or pathologic activation of the pro-inflammatory response in the maternal circulation during the process of labor at term or preterm.
authors.affiliation: Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Cruciani
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Edi
authors.initials: E
authors.lastname: Vaisbuch
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki-Tovi
authors.forename: Zhong
authors.initials: Z
authors.lastname: Dong
authors.forename: Sun Kwon
authors.initials: SK
authors.lastname: Kim
authors.forename: Giovanna
authors.initials: G
authors.lastname: Ogge
authors.forename: Lami
authors.initials: L
authors.lastname: Yeo
authors.forename: Pooja
authors.initials: P
authors.lastname: Mittal
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007743:Labor, Obstetric / Q000097:blood*; D007752:Obstetric Labor, Premature / Q000097:blood*; D011247:Pregnancy; D000683:Serum Amyloid P-Component / Q000032:analysis*; D055815:Young Adult; D000099153:Pentraxins
chemical_list: D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins