Abstract：
OBJECTIVE: To assess the potential of five inflammatory and six angiogenic/antiangiogenic plasma proteins for predicting imminent spontaneous preterm delivery (SPTD; ≤14 days of sampling), microbial invasion of the amniotic cavity and/or intraamniotic inflammation (MIAC/IAI), and composite neonatal morbidity and mortality (CNMM) in women with early preterm premature rupture of membranes (PPROM).
METHODS: This retrospective cohort study included 76 singleton pregnant women with early PPROM (23-30 weeks). Amniotic fluid obtained via amniocentesis was cultured for microorganism detection and assayed for interleukin-6 to define IAI (≥2.6 ng/mL). Plasma C4a, endoglin, endostatin, IGFBP-1, IGFBP-2, MMP-9, PlGF, S100A8, S100A9, S100 A8/A9, and VEGFR-1 levels were determined using ELISA.
RESULTS: Multivariate logistic regression analyses revealed significant associations between (i) high levels of plasma S100A8/A9, SPTD ≤14 days after sampling, and shorter sampling-to-delivery intervals; (ii) elevated plasma MMP-9, S100A9, and S100A8/A9 levels and MIAC/IAI, and (iii) decreased plasma endoglin levels and increased CNMM risk, while adjusting for gestational age at sampling (or delivery) and tocolytic use. The area under the curves of the aforementioned proteins ranged from 0.655 to 0.731 for each outcome. Notably, the SPTD risk increased significantly with increasing plasma S100A8/A9 levels (P for trend < .05).
CONCLUSIONS: Plasma S100A8/A9, MMP-9, S100A9, and endoglin may represent valuable biomarkers associated with SPTD, MIAC/IAI, and CNMM in women with early PPROM. Owing to their less invasive nature, repeatability, and fair-to-moderate diagnostic accuracy, these biomarkers may contribute to risk stratification of PPROM-related complications in the clinical setting.
METHODS: This retrospective cohort study included 76 singleton pregnant women with early PPROM (23-30 weeks). Amniotic fluid obtained via amniocentesis was cultured for microorganism detection and assayed for interleukin-6 to define IAI (≥2.6 ng/mL). Plasma C4a, endoglin, endostatin, IGFBP-1, IGFBP-2, MMP-9, PlGF, S100A8, S100A9, S100 A8/A9, and VEGFR-1 levels were determined using ELISA.
RESULTS: Multivariate logistic regression analyses revealed significant associations between (i) high levels of plasma S100A8/A9, SPTD ≤14 days after sampling, and shorter sampling-to-delivery intervals; (ii) elevated plasma MMP-9, S100A9, and S100A8/A9 levels and MIAC/IAI, and (iii) decreased plasma endoglin levels and increased CNMM risk, while adjusting for gestational age at sampling (or delivery) and tocolytic use. The area under the curves of the aforementioned proteins ranged from 0.655 to 0.731 for each outcome. Notably, the SPTD risk increased significantly with increasing plasma S100A8/A9 levels (P for trend < .05).
CONCLUSIONS: Plasma S100A8/A9, MMP-9, S100A9, and endoglin may represent valuable biomarkers associated with SPTD, MIAC/IAI, and CNMM in women with early PPROM. Owing to their less invasive nature, repeatability, and fair-to-moderate diagnostic accuracy, these biomarkers may contribute to risk stratification of PPROM-related complications in the clinical setting.
摘要：
目的：评估5种炎症和6种血管生成/抗血管生成血浆蛋白预测即将发生的自发性早产（SPTD；取样≤14天）的潜力，羊膜腔微生物入侵和/或羊膜腔内炎症（MIAC/IAI），早期早产胎膜早破（PPROM）妇女的复合新生儿发病率和死亡率（CNMM）。
方法：这项回顾性队列研究包括76名早期PPROM（23-30周）的单胎孕妇。将通过羊膜穿刺术获得的羊水培养用于微生物检测，并测定白细胞介素6以定义IAI（≥2.6ng/mL）。血浆C4a,endoglin,内皮抑素,IGFBP-1，IGFBP-2，MMP-9，PlGF，使用ELISA测定S100A8、S100A9、S100A8/A9和VEGFR-1水平。
结果：多变量逻辑回归分析显示（i）采样后血浆S100A8/A9水平升高，SPTD≤14天，和较短的采样至分娩间隔；（ii）升高的血浆MMP-9，S100A9和S100A8/A9水平和MIAC/IAI，和（iii）降低血浆内皮糖蛋白水平和增加CNMM风险，同时调整采样（或分娩）和保胎使用时的胎龄。对于每个结果,前述蛋白质的曲线下面积范围为0.655至0.731。值得注意的是,随着血浆S100A8/A9水平的升高，SPTD风险显著增加（P<0.05）。
结论：血浆S100A8/A9、MMP-9、S100A9和endoglin可能代表与SPTD相关的有价值的生物标志物，MIAC/IAI,和CNMM在患有早期PPROM的女性中。由于其侵入性较小，重复性,和中等到中等的诊断准确性，这些生物标志物可能有助于临床中PPROM相关并发症的风险分层.
方法：这项回顾性队列研究包括76名早期PPROM（23-30周）的单胎孕妇。将通过羊膜穿刺术获得的羊水培养用于微生物检测，并测定白细胞介素6以定义IAI（≥2.6ng/mL）。血浆C4a,endoglin,内皮抑素,IGFBP-1，IGFBP-2，MMP-9，PlGF，使用ELISA测定S100A8、S100A9、S100A8/A9和VEGFR-1水平。
结果：多变量逻辑回归分析显示（i）采样后血浆S100A8/A9水平升高，SPTD≤14天，和较短的采样至分娩间隔；（ii）升高的血浆MMP-9，S100A9和S100A8/A9水平和MIAC/IAI，和（iii）降低血浆内皮糖蛋白水平和增加CNMM风险，同时调整采样（或分娩）和保胎使用时的胎龄。对于每个结果,前述蛋白质的曲线下面积范围为0.655至0.731。值得注意的是,随着血浆S100A8/A9水平的升高，SPTD风险显著增加（P<0.05）。
结论：血浆S100A8/A9、MMP-9、S100A9和endoglin可能代表与SPTD相关的有价值的生物标志物，MIAC/IAI,和CNMM在患有早期PPROM的女性中。由于其侵入性较小，重复性,和中等到中等的诊断准确性，这些生物标志物可能有助于临床中PPROM相关并发症的风险分层.
