title: Intra-amniotic inflammation predicts microbial invasion of the amniotic cavity but not spontaneous preterm delivery in preterm prelabor membrane rupture.
abstract: OBJECTIVE
  To predict microbial invasion of the amniotic cavity (MIAC) and spontaneous preterm delivery within seven days using a panel of selected proteins from amniotic fluid in a Swedish population of preterm prelabor membrane rupture (PPROM).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Evaluation of intra-amniotic inflammation in preterm premature rupture of membranes.
  
  
  METHODS
  Sixty-six pregnant women with preterm prelabor membrane rupture at 22(+0) -33(+6) weeks' gestational age. Methods. Twenty-seven amniotic fluid proteins were assayed by a multiple immunoassay.
  
  
  METHODS
  The intra-amniotic inflammatory response was evaluated according to the presence of MIAC and the risk of spontaneous preterm delivery within seven days. A prediction model was constructed using logistic regression.
  
  
  RESULTS
  The overall rates of MIAC and spontaneous preterm delivery within seven days were 20 and 50%, respectively. There was a higher inflammatory response in women with MIAC than in those without. Earlier gestational age at delivery and lower birthweight were observed in the presence of microbial invasion of the amniotic cavity. Amniotic fluid interleukin (IL)-6 and IL-10 were the best predictors of MIAC in terms of sensitivity (69%), specificity (81%), positive predictive value (47%), negative predictive value (91%) and a positive likelihood ratio of 3.6. There were no differences in intra-amniotic inflammatory response according to the risk of spontaneous preterm delivery within seven days.
  
  
  CONCLUSIONS
  Amniotic fluid IL-6 and IL-10 are the best inflammatory biomarkers to predict MIAC in women with PPROM. Intra-amniotic inflammation does not predict the occurrence of spontaneous preterm delivery within seven days of PPROM.
authors.affiliation: Maternal Fetal Medicine Department, Hospital Clinic, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. elina.keikkala@hus.fi
authors.forename: Teresa
authors.initials: T
authors.lastname: Cobo
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Holst
authors.forename: David M
authors.initials: DM
authors.lastname: Hougaard
authors.forename: Kristin
authors.initials: K
authors.lastname: Skogstrand
authors.forename: Ulla-Britt
authors.initials: UB
authors.lastname: Wennerholm
authors.forename: Henrik
authors.initials: H
authors.lastname: Hagberg
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000328:Adult; D000650:Amnion / Q000382:microbiology*; D000653:Amniotic Fluid / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D002821:Chorioamnionitis / Q000382:microbiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016753:Interleukin-10