title: A prediction model of histological chorioamnionitis and funisitis in preterm prelabor rupture of membranes: analyses of multiple proteins in the amniotic fluid.
abstract: OBJECTIVE
  To determine the best prediction model of histological chorioamnionitis and funisitis in preterm prelabor rupture of membranes (PPROM) using selected candidate proteins in the amniotic fluid (AF).
  
  
  METHODS
  Prospective cohort study. Twenty-six AF proteins were assayed by a multiple immunoassay from 107 women with membranes rupture from 23+0 to 36+6 weeks. The Czech Republic policy is active management, and the majority of women were delivered within 72 h after the rupture of membranes, except for women with PPROM <28+0 weeks who were managed conservatively. The best predictive models to diagnose histological chorioamnionitis and funisitis were calculated by logistic regression depending on the gestational age (GA) at membrane rupture.
  
  
  RESULTS
  Both IL-6 and a combination of IL-10, and migration inhibiting factor (MIF) were the best predictive models of histological chorioamnionitis and funisitis, respectively, with sensitivity, specificity, positive and negative predictive values and positive likelihood ratio (LR+) of 62, 83, 37, 93 and 3.6 and of 63, 91, 53, 94 and 7.0, respectively. Depending on whether GA at membrane rupture was <32 or ≥ 32 weeks, IL-10, alone or in combination with MIF and triggering receptor expressed on myeloid cells-1, was the strongest inflammatory biomarker for funisitis (LR+10.6 and 36.6, respectively).
  
  
  CONCLUSIONS
  Regardless of the GA at membrane rupture, IL-6 from the AF was the best predictor of histological chorioamnionitis. Amniotic fluid IL-10 was notably accurate in the prediction of funisitis.
authors.affiliation: Maternal Fetal Medicine Department, Hospital Clinic, Institut d' Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain. tcobo@clinic.ub.es
authors.forename: Teresa
authors.initials: T
authors.lastname: Cobo
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: Montse
authors.initials: M
authors.lastname: Palacio
authors.forename: Helena
authors.initials: H
authors.lastname: Hornychova
authors.forename: David M
authors.initials: DM
authors.lastname: Hougaard
authors.forename: Kristin
authors.initials: K
authors.lastname: Skogstrand
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000378:metabolism; D003661:Decision Support Techniques; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D007118:Immunoassay; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D019746:Intramolecular Oxidoreductases / Q000378:metabolism; D016015:Logistic Models; D008263:Macrophage Migration-Inhibitory Factors / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D008263:Macrophage Migration-Inhibitory Factors; D016753:Interleukin-10; D019746:Intramolecular Oxidoreductases; C515598:MIF protein, human