title: The implication of second-trimester amniotic fluid TNF-alpha, cytochrome C and cell death nucleosomes in the prediction of preterm labor and/or premature rupture of membranes.
abstract: OBJECTIVE
  The multifactorial pathway leading to preterm labor possibly includes the implication of apoptosis. This study aimed to clarify the role of amniotic fluid apoptotic molecules (TNF-alpha, cytochrome C and cell death nucleosomes) at midtrimester as possible predictors of preterm labor (PTL) and/or premature rupture of membranes (PROM).
  
  
  METHODS
  In this case-control study, comprising 360 women undergoing genetic amniocentesis and out of whom 38 delivered preterm and 18 out of the latter after PROM, the above apoptotic molecules were determined by ELISA. The 38 cases with PTL and 18 cases with PROM were matched for age with 38 and 18 respective controls delivering at term, and the levels of apoptotic molecules were compared.
  
  
  RESULTS
  Cell death nucleosome levels were found to be significantly associated with preterm delivery. Specifically, for every unit increase in nucleosomes, women were on average 0.2% more likely to deliver preterm (OR: 1.002, CI: 1.0-1.003, p = 0.018). In contrast, such an association was not found concerning the other two apoptotic molecules (TNF-a and Cytochrome C).
  
  
  CONCLUSIONS
  Second-trimester amniotic fluid cell death nucleosomes' levels are significantly associated with preterm delivery and could possibly serve as predicting markers.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Puchner
authors.forename: C
authors.initials: C
authors.lastname: Iavazzo
authors.forename: D
authors.initials: D
authors.lastname: Gourgiotis
authors.forename: M
authors.initials: M
authors.lastname: Boutsikou
authors.forename: S
authors.initials: S
authors.lastname: Baka
authors.forename: D
authors.initials: D
authors.lastname: Hassiakos
authors.forename: E
authors.initials: E
authors.lastname: Kouskouni
authors.forename: E
authors.initials: E
authors.lastname: Economou
authors.forename: A
authors.initials: A
authors.lastname: Malamitsi-Puchner
authors.forename: G
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D016022:Case-Control Studies; D016923:Cell Death; D045304:Cytochromes c / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D006801:Humans; D009707:Nucleosomes / Q000378:metabolism*; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D009707:Nucleosomes; D014409:Tumor Necrosis Factor-alpha; D045304:Cytochromes c