title: Annexin A2 in amniotic fluid: correlation with histological chorioamnionitis, preterm premature rupture of membranes, and subsequent preterm delivery.
abstract: OBJECTIVE
  The aim of this study was to determine whether amniotic fluid levels of annexin A2, a phospholipid-binding protein that is abundant in amnion and regulates fibrin homeostasis, are associated with histological chorioamnionitis, preterm premature rupture of the membranes, and subsequent preterm delivery.
  
  
  METHODS
  Amniotic fluid was obtained from 55 pregnant women with preterm labor and/or preterm premature rupture of the membranes before 32weeks of gestation, and amniotic fluid levels of annexin A2 were measured with a sandwich enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Amniotic fluid levels of annexin A2 in patients with histological chorioamnionitis was higher than that in the remainder (P=0.053), whereas amniotic fluid levels of annexin A2 in patients with preterm premature rupture of the membranes was significantly higher than that in the remainder (P=0.002). Amniotic levels of annexin A2 was a fair test (area under receiver-operator characteristic curve=0.679), and amniotic fluid levels of annexin A2>878.2ng/mL had a sensitivity of 68.8%, a specificity of 65.2%, a positive predictive value of 73.3%, and a negative predictive value of 60.0% for predicting delivery within 2weeks after amniotic fluid sampling. Furthermore, the combined use of amniotic fluid cut-off levels of 878.2ng/mL for annexin A2 and 13.3ng/mL for interleukin-8 improved the specificity (91.3%) and the positive predictive value (89.5%).
  
  
  CONCLUSIONS
  We identified amniotic fluid levels of annexin A2, especially in combination with amniotic fluid levels of interleukin-8, as a novel predictive marker for preterm delivery.
authors.affiliation: Departments of Developmental Medicine Neonatology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. nambaf@email.chop.edu
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Namba
authors.forename: Shihomi
authors.initials: S
authors.lastname: Ina
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitajima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshio
authors.forename: Kazuya
authors.initials: K
authors.lastname: Mimura
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Itaru
authors.initials: I
authors.lastname: Yanagihara
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D017306:Annexin A2 / Q000378:metabolism*; D002821:Chorioamnionitis / Q000378:metabolism*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism*; D006801:Humans; D016209:Interleukin-8 / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000378:metabolism*
chemical_list: D017306:Annexin A2; D016209:Interleukin-8