Matrix metalloproteinase-8 in cervical fluid in early and mid pregnancy: relation to spontaneous preterm delivery.
OBJECTIVE
To evaluate whether matrix metalloproteinase-8 (MMP-8) concentrations in cervical fluid in early and mid pregnancy are associated with subsequent preterm delivery (PTD) preceded by premature preterm rupture of membranes (PPROMs) or preterm labour (PTL) with intact membranes.


METHODS
Cervical swab samples were collected from 5180 women in early and mid pregnancy. MMP-8 was determined by immunofluorometric assay (IFMA). The outcome measure was spontaneous PTD at < 37 weeks' gestation.


RESULTS
The overall distribution and the median cervical fluid MMP-8 concentrations in early and mid pregnancy did not differ in women with term delivery and those with subsequent PTD. However, cervical fluid MMP-8 levels were lower in mid pregnancy in women with PTD preceded by PPROM at < 37 weeks as compared with women who delivered at term and women who had PTD initiated by spontaneous onset of labour (p = 0.016 and p = 0.023, respectively).


CONCLUSIONS
Our data suggest that molecular mechanisms underlying PTL and PPROM differ and MMP-8 in cervical fluid may reflect different functions of this protease. Due to remarkable overlapping of cervical fluid MMP-8 values, this molecule may not have clinical applicability as a biomarker in cervical fluid at least among asymptomatic women in early and mid pregnancy.
Rahkonen
Leena
L
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland. leena.rahkonen@hus.fi
Rutanen
Eeva-Marja
EM
Nuutila
Mika
M
Sainio
Susanna
S
Sorsa
Timo
T
Paavonen
Jorma
J
D000328:Adult; D002584:Cervix Uteri / Q000201:enzymology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000201:enzymology*; D006801:Humans; D007231:Infant, Newborn; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism*; D007752:Obstetric Labor, Premature / Q000201:enzymology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000201:enzymology*; D018709:Statistics, Nonparametric
D020784:Matrix Metalloproteinase 8