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Diagnostic value of amniotic fluid inflammatory biomarkers for subclinical chorioamnionitis
Author(s) -
Liu Yinglin,
Liu Yukun,
Du Chuying,
Zhang Rui,
Feng Ziya,
Zhang Jianping
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.01.007
Subject(s) - subclinical infection , chorioamnionitis , medicine , amniotic fluid , gastroenterology , obstetrics , prospective cohort study , pregnancy , fetus , biology , genetics
Objective To determine the value of measuring amniotic fluid inflammatory biomarkers for diagnosis of subclinical chorioamnionitis. Methods A prospective study was conducted among pregnant women with cervical dilation, preterm premature rupture of membranes, threatened late abortion, or threatened premature labor who attended a tertiary care hospital in Guangzhou, China, between June 1, 2012, and January 31, 2014. Participants were divided into two groups according to the presence or absence of subclinical chorioamnionitis. Surface‐enhanced laser desorption/ionization time‐of‐flight mass spectroscopy (SELDI‐TOF‐MS) was used to detect human neutrophil defensins (HNP‐1 and HNP‐2), calgranulins A (S100 A8), and calgranulins C (S100 A12) in amniocentesis samples. Results Overall, 22 patients had subclinical chorioamnionitis and 17 patients did not. Positive test results for HNP‐2 were noted for more patients with subclinical chorioamnionitis than for those without for HNP‐2 (19 [86%] vs 2 [12%]; P < 0.001), HNP‐1 (19 [86%] vs 5 [29%]; P = 0.001), S100 A12 (20 [91%] vs 9 [53%]; P = 0.011), and S100 A8 (12 [55%] vs 0; P < 0.001). When three or four of these biomarkers were present, the accuracy for a diagnosis of subclinical chorioamnionitis was 89.7%. The sensitivity, specificity, positive predictive value, and negative predictive value were 81.8%, 100.0%, 100.0%, and 81.0%, respectively. Conclusion Detection of inflammatory biomarkers in the amniotic fluid by SELDI‐TOF‐MS exhibited high diagnostic accuracy for subclinical chorioamnionitis.