Correlation of amniotic fluid glucose concentration and intraamniotic infection in patients with preterm labor or premature rupture of membranes

Gauthier, Daniel W.; Meyer, William J.; Bieniarz, Andre

doi:10.1016/0002-9378(91)90480-f

Cited by 76 publications

(31 citation statements)

References 11 publications

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“…Some have reported sterile amniotic fluid [26, 42] while others have found the presence of microorganisms in an unexpectedly high number of cases [13, 65, 104]. The presence of microorganisms in the amniotic cavity elicits, in some cases, an inflammatory response that can be detected by demonstration of an elevation of the amniotic fluid white blood cell count [18, 43, 161, 171], a decrease in amniotic fluid glucose [28, 45, 46, 66, 90, 157, 171], or an elevation in proinflammatory cytokines, such as interleukin-6 (IL-6) [9, 29, 79, 82, 136, 156, 167, 170, 171, 177, 178, 200, 201], MCP-1 [20, 27, 40, 75], and matrix metalloproteinases (MMPs) such as MMP-8 [40, 85, 88, 89, 95, 96, 112, 123, 126, 132, 134, 135]. …”

Section: Introductionmentioning

confidence: 99%

Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and associations with spontaneous early (<32 weeks) and late (>32 weeks) preterm delivery

Gervasi

Romero

Bracalente

et al. 2012

Journal of Perinatal Medicine

135

112

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Introduction Intra-amniotic inflammation is traditionally defined as an elevation of amniotic fluid interleukin (IL)-6. Previous case control studies have suggested an association between an elevated midtrimester amniotic fluid IL-6 and preterm delivery, although such an association has been recently challenged. Intra-amniotic inflammation can also be defined by an elevation of the T-cell chemokine, Interferongamma-inducible protein (IP)-10. An elevation in amniotic fluid IP-10 has been associated with chronic chorioamnionitis, a lesion frequently found in late spontaneous preterm birth and fetal death. In contrast, an elevation in amniotic fluid IL-6 is typically associated with acute chorioamnionitis and funisitis. This study was conducted to examine the relationship between an elevation in amniotic fluid IL-6 in the midtrimester and preterm delivery at or before 32 weeks of gestation, and the amniotic fluid concentration of IP-10 and preterm delivery after 32 weeks of gestation. Materials and methods This cohort study included 847 consecutive women undergoing genetic midtrimester amniocentesis; in 796 cases, amniotic fluid and pregnancy outcome was available for study after exclusion of abnormal karyotype and/or fetal congenital anomalies. Spontaneous preterm delivery was defined as early (≤ 32 weeks) or late (after 32 completed weeks of pregnancy). The amniotic fluid and maternal blood concentrations of IL-6 and IP-10 were measured by specific immunoassays. Results 1) The prevalence of preterm delivery was 8.3% (66/796), while those of early and late spontaneous preterm delivery were 1.5% (n = 12), and 4.5% (n = 36), respectively; 2) patients who had a spontaneous preterm delivery after 32 weeks of gestation had a higher median amniotic fluid IP-10 concentration than those who delivered at term [median 713 pg/mL, inter-quartile range (IQR) 509 – 1427 pg/mL vs. median 589 pg/mL, IQR 402 – 953 pg/mL; P = 0.006] and an elevation of amniotic fluid IP-10 concentration above 502 pg/mL (derived from an ROC curve) was associated with late spontaneous preterm delivery [odds ratio 3.9 (95% CI 1.6 – 9.9)]; 3) patients who had a spontaneous preterm delivery ≤ 32 weeks of gestation had a higher median amniotic fluid IL-6 concentration than those who delivered at term [median 2052 pg/mL, IQR 435 – 3015 pg/mL vs. median 414 pg/mL, IQR 209 – 930 pg/mL; P = 0.006], and an elevated amniotic fluid IL-6 concentration above 1740 pg/mL (derived from an ROC curve) was associated with early spontaneous preterm delivery [odds ratio 9.5 (95% CI 2.9 – 31.1)]; 4) subclinical intra-amniotic inflammation, defined as an elevation of IL-6 (≥ 2.9 ng/mL) or IP-10 (≥ 2.2 ng/mL) concentration above the 95th percentile of patients who had uncomplicated term delivery (n = 652 for IL-6 and n = 633 for IP-10), was observed in 6.3% (50/796) and 5.8% (45/770) of cases, respectively. Although each type of inflammation is a risk factor for spontaneous preterm delivery, many patients had a term delivery without complication; 5) the amniotic fluid ...

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Section: Introductionmentioning

confidence: 99%

Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and associations with spontaneous early (<32 weeks) and late (>32 weeks) preterm delivery

Gervasi

Romero

Bracalente

et al. 2012

Journal of Perinatal Medicine

135

112

View full text Add to dashboard Cite

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“…Proposed additional markers are glucose concentration, lactate dehydrogenase activity, components of the complement system, matrix-metalloproteases (i.e. MMP-8, MMP-9) or pro-inflammatory cytokines [94,95,96]. The results of one of the largest comparative studies of the diagnostic performance of amniotic fluid pro-inflammatory markers for prediction of intra-amniotic infection were recently communicated by Jacobsson et al [97].…”

Section: Invasive Diagnosis Of Intra-amniotic Infection and Inflammentioning

confidence: 99%

Advances in medical diagnosis of intra-amniotic infection

Buhimschi

Nayeri

Laky

et al. 2012

Expert Opinion on Medical Diagnostics

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Introduction Intra-uterine infection is a global problem and a significant contributor to morbidity and perinatal death. The host response to infection causes an inflammatory state that acts synergistically with microbial insult to induce preterm birth and fetal damage. Prompt and accurate diagnosis of intra-amniotic infection in the asymptomatic stage of the disease is critical for improved maternal and neonatal outcomes. Areas Covered This article provides an overview of the most recent progress, challenges and opportunities for discovery and clinical implementation of various maternal serum, cervico-vaginal and amniotic fluid biomarkers in pregnancies complicated by intra-amniotic infection. Expert Opinion Clinically relevant biomarkers are critical to the accurate diagnostic of intra-uterine infection. Front end implementation of such biomarkers will also translate in lower incidence of early-onset neonatal sepsis which is an important determinant of neonatal morbidity and mortality associated with prematurity. However, of the hundreds of differentially expressed proteins, only few may have clinical utility and thus function as biomarkers. The small number of validation studies along with barriers to implementation of technological innovations in the clinical setting are current limitations.

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“…La présence de germes dans le liquide amniotique, identifiée par amniocentèse après RPM, est retrouvée dans 30 à 50 % des cas [20][21][22][23][24][25][26][27][28][29]. Pendant la période de latence, la culture du liquide amniotique met en évidence une flore microbienne diversifiée qui associe Ureaplasma urealyticum, Mycoplasma hominis, bacteroïdes, Streptococcus pneumoniae ainsi que des germes anaérobies [22,30].…”

Section: Infection Intra-utérineunclassified

Les complications et la surveillance pendant la période de latence après une rupture prématurée des membranes avant terme : mise au point

Pasquier

Doret

2008

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Correlation of amniotic fluid glucose concentration and intraamniotic infection in patients with preterm labor or premature rupture of membranes

Cited by 76 publications

References 11 publications

Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and associations with spontaneous early (<32 weeks) and late (>32 weeks) preterm delivery

Midtrimester amniotic fluid concentrations of interleukin-6 and interferon-gamma-inducible protein-10: evidence for heterogeneity of intra-amniotic inflammation and associations with spontaneous early (<32 weeks) and late (>32 weeks) preterm delivery

Advances in medical diagnosis of intra-amniotic infection

Les complications et la surveillance pendant la période de latence après une rupture prématurée des membranes avant terme : mise au point

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