title: Clinical and inflammatory markers in amniotic fluid as predictors of adverse outcomes in preterm premature rupture of membranes.
abstract: OBJECTIVE
  We sought to evaluate gestational age, cervical length, amniotic fluid interleukin (IL)-6, and selected proteomic biomarkers as independent predictors of adverse outcome in preterm premature rupture of membranes (PPROM).
  
  
  METHODS
  This was a prospective cohort study of 65 consecutive women with PPROM (20.0-34.6 weeks). Gestational age, cervical length, amniotic fluid IL-6, and proteomic biomarkers (calgranulins A and C, and neutrophil defensins 1 and 2) were evaluated at diagnosis. The predictive value for intraamniotic infection and neonatal composite morbidity was calculated by logistic regression.
  
  
  RESULTS
  Proteomic biomarkers were independent predictors of intraamniotic infection (odds ratio, 22.1; P=.011) and neonatal composite morbidity (odds ratio, 17.6; P=.02). With the exception of a trend between gestational age and neonatal morbidity (P=.054), none of the other parameters were independent predictors of outcome measures.
  
  
  CONCLUSIONS
  Selected proteomic biomarkers were the only independent predictors of adverse outcomes in PPROM. Contrary to what is reported in preterm labor with intact membranes, gestational age, cervical length, and IL-6 were not.
authors.affiliation: Department of Maternal-Fetal Medicine, Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital Clínic, and the Institut de Investigacions Biomèdiques August Pi-Sunyer, University of Barcelona, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Cobo
authors.forename: Montse
authors.initials: M
authors.lastname: Palacio
authors.forename: Mónica
authors.initials: M
authors.lastname: Martínez-Terrón
authors.forename: Aleix
authors.initials: A
authors.lastname: Navarro-Sastre
authors.forename: Jordi
authors.initials: J
authors.lastname: Bosch
authors.forename: Xavier
authors.initials: X
authors.lastname: Filella
authors.forename: Eduard
authors.initials: E
authors.lastname: Gratacós
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis* / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018836:Inflammation Mediators / Q000032:analysis* / Q000378:metabolism; D015850:Interleukin-6 / Q000032:analysis / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D018570:Risk Assessment; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6