Comparison of amniotic fluid matrix metalloproteinase-8 and cathelicidin in the diagnosis of intra-amniotic infection

J Perinatol. 2016 Dec;36(12):1049-1054. doi: 10.1038/jp.2016.147. Epub 2016 Sep 1.

Abstract

Objective: To evaluate the association of amniotic fluid (AF) matrix metalloproteinase-8 (MMP-8) and cathelicidin concentrations with microbial invasion of the amniotic cavity (MIAC) in pregnancies with preterm prelabor rupture of the membranes or intact membranes.

Study design: Amniocentesis was performed in 54 singleton pregnancies between 22+0 and 34+2 gestational weeks with suspected intra-amniotic infection. AF-MMP-8 was analysed by immunoassay and AF-cathelicidin by commercial ELISA. Standard biochemical methods, molecular microbiology and culture techniques were used.

Results: MIAC was present in 18 (33%) women. The cutoff value for the diagnosis of MIAC was 41.5 ng ml-1 for AF-MMP-8, and 11.6 ng ml-1 for AF-cathelicidin. With these cutoff values AF-MMP-8 had a sensitivity of 100%, specificity of 69%, positive predictive value of 62% and negative predictive value of 100% for MIAC. The corresponding values for AF-cathelicidin were 89, 81, 70 and 94%.

Conclusion: The performance of AF-cathelicidin in the prediction of MIAC is comparable to AF-MMP-8.

MeSH terms

  • Adult
  • Amniocentesis
  • Amniotic Fluid / chemistry*
  • Amniotic Fluid / enzymology
  • Amniotic Fluid / microbiology
  • Antimicrobial Cationic Peptides / analysis*
  • Antimicrobial Cationic Peptides / metabolism
  • Biomarkers / analysis
  • Cathelicidins
  • Chorioamnionitis / enzymology
  • Chorioamnionitis / metabolism
  • Female
  • Fetal Membranes, Premature Rupture / diagnosis*
  • Fetal Membranes, Premature Rupture / enzymology
  • Gestational Age
  • Humans
  • Matrix Metalloproteinase 8 / analysis*
  • Matrix Metalloproteinase 8 / metabolism
  • Obstetric Labor, Premature / enzymology
  • Predictive Value of Tests
  • Pregnancy
  • Prospective Studies
  • ROC Curve

Substances

  • Antimicrobial Cationic Peptides
  • Biomarkers
  • Matrix Metalloproteinase 8
  • Cathelicidins