Association of Amniotic Fluid Concentrations of Monocyte Chemotactic Protein-1 with Intrauterine Infections and Perinatal Outcomes in Preterm Labor / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To examine if amniotic fluid (AF) monocyte chemotactic protein-1 (MCP-1) concentrations are useful in the identification of intrauterine infection and pregnancy outcomes in preterm labor with intact membranes. METHODS: The study population consists of 65 patients who received amniocentesis for preterm labor with intact membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. MCP-1 was determined by a sensitive and specific immunoassay. Fisher's exact test, Mann-Whitney U test, receiver operating characteristic curve, survival techniques, logistic regression, and Spearman correlation were used for statistical analysis. RESULTS: (1) Patients with a positive amniotic fluid culture had a significantly higher median AF MCP-1 concentration than those with negative results (median, 9.0 ng/mL; range, 0.45-40.5 ng/mL; vs median, 0.82 ng/mL; range, 0.06-30.1 ng/mL; P1.9 ng/mL had a significantly shorter median interval to delivery, the higher rate of histologic chorioamnionitis, preterm delivery within 2 and 5 days, and the occurrence of congenital proven or suspected sepsis than did those with AF MCP-1 concentration of <1.9 ng/mL after adjustment for gestational age (P<.05). (3) There was strong correlation between AF MCP-1 concentrations and AF interleukin-6 concentrations (r=.881, P<.001). CONCLUSION: AF MCP-1 determinations are useful in the identification of intrauterine infection, preterm delivery, and neonatal infectious complication in preterm labor with intact membranes.