| Association of Amniotic Fluid Concentrations of Monocyte Chemotactic Protein-1 with Intrauterine Infections and Perinatal Outcomes in Preterm Labor. |
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Soon Sup Shim, Hyun Soo Park, June Hee Lim, Jae Yoon Shim, Dae Woo Chun, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon, Hee Chul Syn |
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Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. |
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| Abstract |
OBJECTIVE
To examine if amniotic fluid (AF) monocyte chemotactic protein-1 (MCP-1) concentrations are useful in the identification of intrauterine infection and pregnancy outcomes in preterm labor with intact membranes. METHODS: The study population consists of 65 patients who received amniocentesis for preterm labor with intact membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. MCP-1 was determined by a sensitive and specific immunoassay. Fisher's exact test, Mann-Whitney U test, receiver operating characteristic curve, survival techniques, logistic regression, and Spearman correlation were used for statistical analysis. RESULTS: (1) Patients with a positive amniotic fluid culture had a significantly higher median AF MCP-1 concentration than those with negative results (median, 9.0 ng/mL; range, 0.45-40.5 ng/mL; vs median, 0.82 ng/mL; range, 0.06-30.1 ng/mL; P<.01). (2) Patients with AF MCP-1 concentration of >1.9 ng/mL had a significantly shorter median interval to delivery, the higher rate of histologic chorioamnionitis, preterm delivery within 2 and 5 days, and the occurrence of congenital proven or suspected sepsis than did those with AF MCP-1 concentration of <1.9 ng/mL after adjustment for gestational age (P<.05). (3) There was strong correlation between AF MCP-1 concentrations and AF interleukin-6 concentrations (r=.881, P<.001). CONCLUSION: AF MCP-1 determinations are useful in the identification of intrauterine infection, preterm delivery, and neonatal infectious complication in preterm labor with intact membranes. |
| Key Words:
Amniotic fluid monocyte chemotactic protein-1 (MCP-1), Pregnancy outcome, Intrauterine infection, Preterm delivery |
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