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.
Artigo
em Inglês
| WPRIM
| ID: wpr-78889
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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Resultado da Gravidez
/
Modelos Logísticos
/
Corioamnionite
/
Metaloproteinase 8 da Matriz
/
Parto
/
Nascimento Prematuro
/
Amniocentese
/
Líquido Amniótico
/
Inflamação
/
Trabalho de Parto Prematuro
Tipo de estudo:
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Gravidez
Idioma:
Inglês
Revista:
Obstetrics & Gynecology Science
Ano de publicação:
2013
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS