Systemic and local inflammatory response in women with preterm prelabor rupture of membranes.
OBJECTIVE
To evaluate the inflammatory pattern in maternal circulation, amniotic cavity, cervix and vagina from women with preterm prelabor rupture of membranes (PPROM) considering the occurrence of microbial invasion of the amniotic cavity (MIAC).


METHODS
A prospective study was performed in 58 women with PPROM before 34+0 weeks of gestational age. Twenty-six proteins were analyzed by a multiple immunoassay in samples of amniotic fluid, serum, cervix and vagina. Association of an inflammatory response in the invasive and non-invasive samples with MIAC was investigated.


RESULTS
The rate of MIAC was 36.2% (21/58). Both amniotic fluid IL-6 and cervical C-reactive protein (CRP) showed to be independent predictors of MIAC. A cut-off level of cervical CRP≥1836 pg/mL showed a detection rate of 75%, false positive rate of 19% and positive and negative predictive values to predict MIAC of 67% and 87%, respectively. There were no independent biomarkers of MIAC either in the serum or vaginal compartment.


CONCLUSIONS
A cervical inflammatory response mediated by CRP was observed in PPROM women with MIAC. Evaluation of serum or vaginal samples did not add valuable information regarding the outcome evaluated.
Maternal-Fetal Medicine Department, ICGON, Hospital Clınic, Universitat de Barcelona, Barcelona, Spain; Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain.
Teresa
T
Cobo
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden ; Institute of Public Health, Oslo, Norway.
Bo
B
Jacobsson
Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Czech Republic.
Marian
M
Kacerovsky
Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, Denmark.
David M
DM
Hougaard
Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, Denmark.
Kristin
K
Skogstrand
Maternal-Fetal Medicine Department, ICGON, Hospital Clınic, Universitat de Barcelona, Barcelona, Spain; Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain.
Eduard
E
Gratacós
Maternal-Fetal Medicine Department, ICGON, Hospital Clınic, Universitat de Barcelona, Barcelona, Spain; Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain.
Montse
M
Palacio
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry / Q000382:microbiology*; D002097:C-Reactive Protein / Q000378:metabolism; D002584:Cervix Uteri / Q000737:chemistry / Q000382:microbiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood / Q000382:microbiology*; D005865:Gestational Age; D016905:Gram-Negative Bacterial Infections / Q000097:blood / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000382:microbiology*; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000097:blood / Q000382:microbiology; D015850:Interleukin-6 / Q000097:blood; D009181:Mycoses / Q000097:blood / Q000382:microbiology*; D007752:Obstetric Labor, Premature / Q000097:blood / Q000382:microbiology*; D011247:Pregnancy; D011446:Prospective Studies; D014621:Vagina / Q000737:chemistry / Q000382:microbiology
C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein