The frequency and clinical significance of intra-amniotic inflammation defined as an elevated amniotic fluid matrix metalloproteinase-8 in patients with preterm labor and low amniotic fluid white blood cell counts
Obstetrics & Gynecology Science
; : 167-175, 2013.
Article
en En
| WPRIM
| ID: wpr-78889
Biblioteca responsable:
WPRO
ABSTRACT
OBJECTIVE: To determine the frequency and clinical significance of intra-amniotic inflammation (IAI) defined as an elevated amniotic fluid (AF) matrix metalloproteinase-8 (MMP-8) concentration in patients with preterm labor and intact membranes (PTL) and low AF white blood cell (WBC) counts. METHODS: Adverse pregnancy outcomes were compared according to the presence or absence of IAI in 220 singleton gestations who underwent amniocentesis due to PTL (gestational age or =23 ng/mL). RESULTS: IAI was present in 19% of study population. Adverse pregnancy outcomes were significantly more frequent in patients with IAI than in those without IAI (preterm birth within 5 days of amniocentesis, 88% vs. 41%; acute-HCA, 47% vs. 11%; positive AF culture, 10% vs. 2%; each for P<0.05). Patients with IAI had a significantly shorter median amniocentesis-to-delivery interval than those without IAI (7.8 hours [0.01-3,307.3 hours] vs. 310.3 hours [0.01-2,973.8 hours]; P<0.001 from survival analysis). Multiple logistic regression analysis demonstrated that only an IAI (odds ratio, 3.3; 95% confidence interval, 1.5-7.3; P<0.005) retained a statistical significance in the prediction of acute-HCA after other confounding variables were adjusted. CONCLUSION: Approximately one-fifth of patients with PTL and low AF WBC counts have an evidence of IAI and are at risk for impending preterm delivery and acute-HCA when AF MMP-8 concentration is used.
Palabras clave
Texto completo:
1
Índice:
WPRIM
Asunto principal:
Resultado del Embarazo
/
Modelos Logísticos
/
Corioamnionitis
/
Metaloproteinasa 8 de la Matriz
/
Parto
/
Nacimiento Prematuro
/
Amniocentesis
/
Líquido Amniótico
/
Inflamación
/
Trabajo de Parto Prematuro
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Obstetrics & Gynecology Science
Año:
2013
Tipo del documento:
Article