Mid-trimester maternal plasma cytokines and CRP as predictors of spontaneous preterm birth
Mid-trimester maternal plasma cytokines and CRP as predictors of spontaneous preterm birth
复制标题
DOI：
10.1016/j.cyto.2009.08.014
复制
发表时间：
2010-01-01
期刊：
影响因子：
3.8
通讯作者：
Thorsen, Poul
中科院分区：
文献类型：
--
作者：
Kramer, Michael S.;Kahn, Susan R.;Thorsen, Poul
Most previous studies of maternal cytokines and preterm birth have analyzed immunologic biomarkers after the onset of labor or membrane rupture: fewer have examined the systemic (blood) immune response prior to labor onset. We carried out a case-control study nested in a large (n = 5337) prospective, multi-center cohort. Cohort women had an interview, examination, and venipuncture at 2426 weeks. Frozen plasma samples in women with spontaneous preterm birth (n = 207) and approximately 2 term controls per case (n = 444) were analyzed using Luminex multianalyte profiling technology. Fresh placentas were fixed, stained, and blindly assessed for histologic evidence of infection/inflammation, decidual vasculopathy, and infarction, and vaginal swabs were analyzed for bacterial vaginosis and fetal fibronectin concentration. High maternal matrix metalloproteinase-9 (MMP-9) concentration, but none of the other cytokines or C-reactive protein (CRP), was significantly associated with spontaneous preterm birth [adjusted OR = 1.7 (1.1-2.4)] and showed a dose-response relation across quartiles. No association was observed, however, between maternal MMP-9 and placental infection/inflammation, bacterial vaginosis, or vaginal fetal fibronectin concentration. Our results require confirmation in future studies but suggest that a systemic immune response implicating MMP-9 may have an etiologic role in spontaneous preterm birth. (C) 2009 Elsevier Ltd. All rights reserved.
