title: Amniotic fluid soluble Toll-like receptor 4 in pregnancies complicated by preterm prelabor rupture of the membranes.
abstract: OBJECTIVE
  To determine amniotic fluid soluble Toll-like receptor 4 (sTLR4) levels in women with preterm prelabor rupture of the membranes according to the presence of microbial invasion of the amniotic cavity and histological chorioamnionitis and its relation to neonatal outcome.
  
  
  METHODS
  One hundred two women with singleton pregnancies with a gestational age between 24 + 0 and 36 + 6 weeks were included in a prospective cohort study. Amniocenteses were performed, and the concentrations of sTLR4 in the amniotic fluid were determined using sandwich enzyme-linked immunosorbent assay technique.
  
  
  RESULTS
  Women with the presence of microbial invasion of the amniotic cavity had higher sTLR4 levels [median 54.2 ng/mL, interquartile range (IQR) 10.15-289.9] than those without this condition (median 18.1 ng/mL, IQR 8.1-29.9; p = 0.001). Women with the presence of histological chorioamnionitis had a higher sTLR4 level (median 28.0 ng/mL, IQR 11.15-178.1) compared with women without histological chorioamnionitis (median 13.0 ng/mL, IQR 7.8-28.7; p = 0.003). A mixed linear model was used to adjust for confounders. The difference was found only between women with and without microbial invasion of the amniotic cavity in this model.
  
  
  CONCLUSIONS
  Microbial invasion of the amniotic cavity was associated with higher amniotic fluid sTLR4 levels independent of confounders.
authors.affiliation: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. kacermar@fnhk.cz
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: Ctirad
authors.initials: C
authors.lastname: Andrys
authors.forename: Helena
authors.initials: H
authors.lastname: Hornychova
authors.forename: Lenka
authors.initials: L
authors.lastname: Pliskova
authors.forename: Kinga
authors.initials: K
authors.lastname: Lancz
authors.forename: Ivana
authors.initials: I
authors.lastname: Musilova
authors.forename: Marcela
authors.initials: M
authors.lastname: Drahosova
authors.forename: Radka
authors.initials: R
authors.lastname: Bolehovska
authors.forename: Vojtech
authors.initials: V
authors.lastname: Tambor
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism* / Q000382:microbiology; D002821:Chorioamnionitis / Q000378:metabolism; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism* / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000378:metabolism; D009174:Mycoplasma / Q000302:isolation & purification; D009175:Mycoplasma Infections / Q000276:immunology; D011247:Pregnancy; D012189:Retrospective Studies; D051197:Toll-Like Receptor 4 / Q000378:metabolism*
chemical_list: C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4