Transactions of the Twenty-First Annual Meeting of the Society for Maternal-Fetal Medicine—ContinuedAn elevated amniotic fluid matrix metalloproteinase-8 level at the time of mid-trimester genetic amniocentesis is a risk factor for spontaneous preterm delivery☆,☆☆
Section snippets
Study design
A case-control study was designed with stored amniotic fluid obtained from women who underwent mid-trimester genetic amniocentesis. Nineteen patients with spontaneous preterm delivery before 32 weeks of gestation were matched for maternal age (within 5 years), parity (nullipara vs primipara or multipara), gestational age at amniocentesis (within 2 weeks), and year of amniocentesis (within 3 years) with 95 controls who delivered after 37 weeks of gestation (1:5 matching). Cases with abnormal
Results
The clinical characteristics of the study population are shown in Table I.Characteristic Spontaneous preterm delivery (n = 19) Term delivery (n = 95) P Mean maternal age, y (± SD) 32.8 ± 4.9 32.8 ± 4.3 NS Nulliparity 6 (32) 30 (32) NS History of spontaneous preterm delivery 1 (5) 2 (2) NS Indication for amniocentesis Maternal age (≥35 y) 9 (47) 42 (44) NS Risk of Down syndrome by serum marker* 3 (16) 27 (28) NS Elevated MSAFP 5 (26) 12 (13) NS Anomaly of previous baby
Comment
During the course of an inflammatory process, IL-6 and MMP-8 accumulate in body fluids (eg, crevicular, synovial, and amniotic fluid)11, 14 and, therefore, we postulate that an increased concentration of these substances in amniotic fluid is an index of the presence of intra-amniotic inflammation. Because this process is often present for weeks before preterm delivery (see Table III), inflammation must be considered chronic in nature. Inasmuch as 42% of early preterm deliveries (<32 weeks) were
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2020, American Journal of Obstetrics and GynecologyCitation Excerpt :The matrix metalloproteinase-8 (MMP-8) and interleukin-8 concentrations were measured in the samples of stored fluid (supernatant of centrifuged amniotic fluid obtained by amniocentesis) with a commercially available enzyme-linked immunosorbent assay (ELISA; R&D Systems, Minneapolis, MN). Intraamniotic inflammation was defined when the MMP-8 concentration was >23 ng/mL, based on previous reports.26,78,88–101 The sensitivity of the test for MMP-8 was 0.058 ng/mL, and that for interleukin-8 was 0.0075 ng/mL.
Fetal and Maternal Responses to Intraamniotic Infection
2017, Fetal and Neonatal Physiology, 2-Volume Set
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Supported by a grant (2000-N-NL-01-C-078) from the Korea Institute of Science and Technology Evaluation and Planning (KISTEP), Republic of Korea.
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Reprint requests: Bo Hyun Yoon, MD, PhD, Department of Obstetrics and Gynecology, College of Medicine, Seoul National University College of Medicine, Seoul, 110-744, Korea.