title: Accuracy of several maternal seric markers for predicting histological chorioamnionitis after preterm premature rupture of membranes: a prospective and multicentric study.
abstract: OBJECTIVE
  To assess and compare several maternal seric markers for the prediction of histological chorioamnionitis (HCA) after preterm premature rupture of membranes (PPROM). Study design A prospective and multicentric observational study was undertaken, including six French tertiary referral centres. Pregnant women over 18 years, with PPROM between 22+0 and 36+6 WG were enrolled. A blood sample was obtained before delivery and analysed for C-Reactive Protein (CRP), InterCellular Adhesion Molecule-1 (ICAM-1), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Matrix-Metalloproteinase 8 and 9 (MMP-8, MMP-9), Triggering receptor on myeloid cells (TREM-1), and Human Neutrophile Peptides (HNP). HCA was determined by histological examination distinguishing maternal from fetal inflammatory response. Placental analyses and biological assays were performed in duplicate. Comparison of maternal seric markers levels in women with or vs. without HCA was performed, using a non-parametric Receiver Operating Characteristic.
  
  
  RESULTS
  295 women were kept for analysis. The prevalence of HCA was 42.7% (126/295). The concentrations of MMP-8, MMP-9, HNP and CRP were higher in HCA vs. the non-HCA group (P<0.05) whereas the concentrations of ICAM- 1, IL-6, IL-8 were not different (P>0.05). The ROC curve with the largest AUC was for CRP (AUC; 0.70; 95% CI; 0.64-0.77) and it was significantly higher than those for MMP-8, MMP-9, or HNP (P<0.03).
  
  
  CONCLUSIONS
  CRP was the best maternal marker for predicting HCA in women with PPROM.
authors: Hospices Civils de Lyon, Service de gynécologie-obstétrique de la Croix-Rousse, F-69004 Lyon, France; Inserm, U1032, LabTau, F-69003 Lyon, France; Université de Lyon, F-69003 Lyon, France. Electronic address: jonathan.caloone@chu-lyon.fr.
authors: Jonathan
authors: J
authors: Caloone
authors: CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69622 Villeurbanne, France; Hospices Civils de Lyon, Service de Biostatistique, F-69003 Lyon, France.
authors: Muriel
authors: M
authors: Rabilloud
authors: CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69622 Villeurbanne, France; Hospices Civils de Lyon, Service de Biostatistique, F-69003 Lyon, France.
authors: Florent
authors: F
authors: Boutitie
authors: Hospices Civils de Lyon, Service d'anatomopathologie du Centre Hospitalier Lyon-Sud, F-69495 Pierre-Bénite, France.
authors: Alexandra
authors: A
authors: Traverse-Glehen
authors: Hospices Civils de Lyon, Service d'anatomopathologie du Centre Hospitalier de la Croix-Rousse, 69004 Lyon, France.
authors: Fabienne
authors: F
authors: Allias-Montmayeur
authors: Hospices Civils de Lyon, Service d'immunologie du Centre Hospitalier Lyon-Sud, F-69495 Pierre-Bénite, France.
authors: Laure
authors: L
authors: Denis
authors: Hospices Civils de Lyon, Service de biochimie de la Croix-Rousse, F-69004 Lyon, France.
authors: Catherine
authors: C
authors: Boisson-Gaudin
authors: Hospices Civils de Lyon, Service de Biostatistique, F-69003 Lyon, France.
authors: Isabelle Jaisson
authors: IJ
authors: Hot
authors: Hospices Civils de Lyon, Service de Biostatistique, F-69003 Lyon, France.
authors: Pascale
authors: P
authors: Guerre
authors: Hospices Civils de Lyon, Service de gynécologie-obstétrique de la Croix-Rousse, F-69004 Lyon, France; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69622 Villeurbanne, France.
authors: Marion
authors: M
authors: Cortet
authors: Hospices Civils de Lyon, Service de gynécologie-obstétrique de la Croix-Rousse, F-69004 Lyon, France; Université de Lyon , Lyon I, Université Claude-Bernard, Lyon, France; INSERM U846, Stem Cell and Brain Research Institute, F-69500 Bron, France.
authors: Cyril
authors: C
authors: Huissoud
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002821:Chorioamnionitis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D020784:Matrix Metalloproteinase 8 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008562:Membrane Glycoproteins / Q000097:blood; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D011446:Prospective Studies; D011971:Receptors, Immunologic / Q000097:blood; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: C-reactive protein; Histological choriomanionitis; Maternal seric markers; Prediction; Prospective and multicentric study