Intraamniotic Inflammation in Women with Preterm Prelabor Rupture of Membranes

• Published in: PloS one 2015-07, Vol.10 (7), p.e0133929-e0133929
• Main Authors: Musilova, Ivana, Kutová, Radka, Pliskova, Lenka, Stepan, Martin, Menon, Ramkumar, Jacobsson, Bo, Kacerovsky, Marian
• Format: Article
• Language: English
• Subjects: Adult; Amniocentesis; Amniotic fluid; Amniotic Fluid - metabolism; Amniotic Fluid - microbiology; Antibiotics; Bacteria; Biochemistry; Chlamydia; Chlamydia trachomatis; Chorioamnionitis - epidemiology; Chorioamnionitis - etiology; Chorioamnionitis - microbiology; Cytokines; Female; Fetal Membranes, Premature Rupture; Gestational age; Gynecology; Health risk assessment; Humans; Immunoassay; Infant, Newborn; Inflammation; Interleukin; Interleukin 6; Interleukin-6 - metabolism; Medicine; Membranes; Microorganisms; Morbidity; Mycoplasma hominis; Neonates; Obstetrics; Pattern recognition; Pregnancy; Pregnancy complications; Pregnant women; Prevalence; RNA; RNA, Ribosomal, 16S; rRNA 16S; Rupture; Rupturing; Sexually transmitted diseases; STD; Subgroups; Ureaplasma
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0133929

To characterize subgroups of preterm prelabor rupture of membranes (PPROM) and short-term neonatal outcomes based on the presence and absence of intraamniotic inflammation (IAI) and/or microbial invasion of the amniotic cavity (MIAC). One hundred and sixty-six Caucasian women with singleton pregnancies were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis (n=166) and were assayed for interleukin-6 levels by a lateral flow immunoassay. The presence of Ureaplasma species, Mycoplasma hominis, Chlamydia trachomatis, and 16S rRNA was evaluated in the amniotic fluid. IAI was defined as amniotic fluid IL-6 values, measured by a point of care test, higher than 745 pg/mL. Microbial-associated IAI (IAI with MIAC) and sterile intraamniotic inflammation (IAI alone) were found in 21% and 4%, respectively, of women with PPROM. Women with microbial-associated IAI had higher microbial loads of Ureaplasma species in the amniotic fluid than women with MIAC alone. No differences in the short-term neonatal morbidity with respect to the presence of microbial-associated IAI, sterile IAI and MIAC alone were found after adjusting for the gestational age at delivery in women with PPROM. Microbial-associated but not sterile intraamniotic inflammation is common in Caucasian women with PPROM. The gestational age at delivery but not the presence of inflammation affects the short-term neonatal morbidity of newborns from PPROM pregnancies.