title: The relationship between the intensity of intra-amniotic inflammation and the presence and severity of acute histologic chorioamnionitis in preterm gestation.
abstract: OBJECTIVE
  Acute histologic chorioamnionitis (HCA) is associated with an increased risk of perinatal mortality and morbidity. The purpose of this study was to determine the relationship between the intensity of intra-amniotic inflammation (IAI) and the severity of acute HCA in preterm gestation.
  
  
  METHODS
  The relationship between the intensity of IAI and the presence and severity of acute HCA was examined in 412 patients with singleton gestations who delivered within 120 h of transabdominal amniocentesis. The concentration of amniotic fluid (AF) matrix metalloproteinase (MMP)-8 was assayed to determine the presence and intensity of IAI. Acute HCA was defined as the presence of inflammatory change in any tissue samples according to the criteria previously reported. The total grade of acute HCA was used to determine the severity of HCA.
  
  
  RESULTS
  (1) Patients with IAI had a significantly higher rate of acute HCA than those without IAI [76.9% (133/173)] versus 20.9% (50/239), p < 0.001]. The AF MMP-8 concentration was significantly higher in patients with acute HCA than in those without acute HCA (median [range]; 188.3 ng/ml [0.3-6142.6] versus 1.8 ng/ml [0.3-2845.5], p < 0.001); (2) Of 183 patients with acute HCA, the AF MMP-8 concentration was positively correlated with the severity of acute HCA (p < 0.001).
  
  
  CONCLUSIONS
  AF MMP-8 concentration was not only a predictor of the presence of acute HCA, but its concentration also correlated with the severity of acute HCA. The higher the intensity of IAI, the worse the degree of acute HCA in preterm gestation.
authors.affiliation: a Department of Obstetrics and Gynecology , Seoul National University College of Medicine , Seoul , Republic of Korea .
authors.forename: Sun Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Park
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Oh
authors.forename: Jong Kwan
authors.initials: JK
authors.lastname: Jun
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Yoon
mesh_terms: D000208:Acute Disease; D000328:Adult; D000649:Amniocentesis / Q000706:statistics & numerical data; D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism; D002821:Chorioamnionitis / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000453:epidemiology / Q000473:pathology*; D020784:Matrix Metalloproteinase 8 / Q000032:analysis / Q000378:metabolism; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D015995:Prevalence; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8
keywords: Amniotic fluid; matrix metalloproteinase-8; prematurity; preterm birth