METHODS: This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within 7 days of admission with gestational ages between 22+0 and 34+6 weeks. The sFlt-1/PlGF ratio and IL-6 were assessed in stored samples of maternal serum, amniotic fluid, and umbilical cord serum using Elecsys® sFlt-1, PlGF, and IL-6 immunoassays.
RESULTS: Women with MVM had a higher sFlt-1/PlGF ratio in the maternal serum, compared to those without MVM (19.9 vs. 4.6; p < 0.0001), but not in the amniotic fluid or umbilical cord blood. A cut-off value of 8 for the sFlt-1/PlGF ratio in maternal serum was identified as optimal for predicting MVM in patients with PTL. Women with HCA had higher concentrations of IL-6 in maternal serum, compared to those without HCA (11.1 pg/mL vs. 8.4 pg/mL; p = 0.03), amniotic fluid (9,216 pg/mL vs. 1,423 pg/mL; p < 0.0001), and umbilical cord blood (20.7 pg/mL vs. 10.7 pg/mL, p = 0.002). Amniotic-fluid IL-6 showed the highest predictive value. A cut-off value of IL-6 concentration in the amniotic fluid of 5,000 pg/mL was found to be optimal for predicting HCA in PTL.
CONCLUSIONS: Maternal serum sFlt-1/PlGF and amniotic fluid IL-6 concentrations can be used for liquid biopsy to predict placental lesions in women with PTL who deliver within 7 days.
结果:患有MVM的女性在母体血清中具有较高的sFlt-1/PlGF比率,与没有MVM的人相比(19.9vs.4.6;p&lt;0.0001),但不在羊水或脐带血中。母体血清中sFlt-1/PlGF比率的截断值8被鉴定为预测PTL患者中的MVM的最佳。患有HCA的妇女在母体血清中有较高浓度的IL-6,与不含HCA的那些相比(11.1pg/mLvs.8.4pg/mL;p=0.03),羊水(9,216pg/mL与1,423pg/mL;p<0.0001),和脐带血(20.7pg/mL与10.7pg/mL,p=0.002)。羊水IL-6的预测价值最高。发现羊水中IL-6浓度的截断值为5,000μg/mL对于预测PTL中的HCA是最佳的。
结论:孕妇血清sFlt-1/PlGF和羊水IL-6浓度可用于液体活检,以预测在7天内分娩的PTL妇女的胎盘病变。