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  • Original Article
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Mid-trimester amniotic fluid pro-inflammatory biomarkers predict the risk of spontaneous preterm delivery in twins: a retrospective cohort study

Journal of Perinatology volume 35, pages 542–546 (2015)Cite this article

Subjects

Abstract

Objective:

To evaluate the association between the concentrations of immune-related proteins in mid-trimester amniotic fluid (AF) and the subsequent risk of spontaneous preterm delivery in twins.

Study Design:

The study population consisted of consecutive women with a twin pregnancy who underwent clinically indicated genetic amniocentesis at 15 to 20 weeks, and had a subsequent spontaneous delivery in the early preterm period (<32 weeks (cases)) or at term (37 to 42 weeks (controls)). AF was analyzed for cytokines (interleukin (IL)-1ß, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13 and IL-15, interferon-γ, tumor necrosis factor-α), matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9 and MMP-12), and chemokines (complement factor-D/Adipsin, Serpin E1/PAI-1, Adiponectin/Acrp30, C-Reactive Protein, CCL2/MCP-1, Leptin, Resistin) using multiplex immunoassay kits. The association between AF protein levels and subsequent early preterm birth were examined.

Result:

A total of 96 sets of twins were enrolled, including 17 early preterm birth cases and 79 term controls. AF concentrations of IL-6, IL-8, MMP-3, MMP-8 and MMP-9, and CCL2/MCP-1 were significantly higher in cases than controls. Among these analytes, the combination of AF IL-8 and MMP-9 values had the highest predictive value for early preterm birth. The risk was 8% (10/132) for IL-8<1200 pg ml−1 and MMP-9<1000 pg ml−1, 30% (15/50) for IL-8>1200 pg ml−1 or MMP-9>1000 pg ml−1, and 90% (9/10) for IL-8>1200 pg ml−1 and MMP-9>1000 pg ml−1 (P<0.001).

Conclusion:

High concentrations of IL-8 and MMP-9 in mid-trimester AF in twins predicted well the risk of early preterm birth.

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Acknowledgements

This study was supported by a grant of the Korea Health R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI12C00240300) and by a grant of the Seoul National University Hospital Research Fund (03-2012-0160).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea

    S M Lee, J S Park, E J Kim, S M Kim, J Lee, B J Kim, C-W Park & J K Jun

  2. Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea

    S M Lee & B J Kim

  3. Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, USA

    E R Norwitz

  4. Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea

    S Oh

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  1. S M Lee
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Correspondence to J S Park.

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DISCLAIMER

This study was presented at the 34th Annual Meeting of the Society for Maternal–Fetal Medicine, New Orleans, LA, USA, 3–8 February 2014.

Supplementary Information accompanies the paper on the Journal of Perinatology website

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Lee, S., Park, J., Norwitz, E. et al. Mid-trimester amniotic fluid pro-inflammatory biomarkers predict the risk of spontaneous preterm delivery in twins: a retrospective cohort study. J Perinatol 35, 542–546 (2015). https://doi.org/10.1038/jp.2015.29

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