Amniotic fluid interleukin-18 at mid-trimester genetic amniocentesis: relationship to intraamniotic microbial invasion and preterm delivery
Amniotic fluid interleukin-18 at mid-trimester genetic amniocentesis: relationship to intraamniotic microbial invasion and preterm delivery
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DOI：
10.1111/j.1471-0528.2009.02364.x
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发表时间：
2009-12-01
影响因子：
5.8
通讯作者：
Antsaklis, A.
中科院分区：
文献类型：
--
作者：
Daskalakis, G.;Thomakos, N.;Antsaklis, A.
目的探讨羊水中白细胞介素18（IL-18）的检测价值（AF IL-18）在诊断羊膜腔微生物侵入和预测早产（PTD）中的作用。设计分析2006年2月至2007年9月期间在遗传性羊膜穿刺术后前瞻性收集的AF结果。将羊水样品转移到实验室进行需氧和厌氧细菌培养、解脲脲原体培养和IL-18测定。所有早产（< 37周妊娠）的妇女组成了研究组。对照组由随后的两名妇女组成，她们也在同一时期接受了子宫穿刺术，并在足月分娩了一名正常的新生儿，与母亲年龄相匹配，主要结果指标AF IL-18水平与羊膜腔微生物侵袭和PTD风险之间的关系。（< 37周）与96个对照组匹配。与对照组（中位数= 322.1 pg/ml，四分位数间距：277.7-414.4）相比，早产组具有显著更高的IL-18浓度（中位数= 609 pg/ml，四分位数间距：445.7-782.7），（P < 0.001）。IL-18水平也显著高于羊水培养阳性者（P < 0.001）（中位数= 697.7，四分位距：609.0-847.2）（中位数= 330.9 pg/ml，四分位距：结论妊娠中期AF IL-18浓度升高可鉴别羊水内感染和自发性PTD的风险。
ObjectiveTo determine the value of amniotic fluid interleukin-18 (AF IL-18) in the diagnosis of microbial invasion of the amniotic cavity and prediction of preterm delivery (PTD).DesignAnalysis of the results of AF collected prospectively following genetic amniocentesis between February 2006 and September 2007.SettingA tertiary referral centre for fetal medicine.MethodsFollowing amniocentesis, a sample of amniotic fluid was transferred to the laboratory for aerobic and anaerobic bacterial cultures, Ureaplasma urealyticum culture and IL-18 assays. All women who delivered preterm (< 37 weeks of gestation) formed the study group. The control group consisted of the two subsequent women who also underwent amniocentesis during the same time period and delivered a normal neonate at term, matched for maternal age, parity and indication for amniocentesis.Main outcome measuresThe relationship between AF IL-18 levels and the risk of both microbial invasion of the amniotic cavity and PTD.ResultsForty-eight women who delivered preterm (< 37 weeks) were matched with 96 controls. The preterm delivery group had significantly higher concentrations of IL-18 (median = 609 pg/ml, interquartile range: 445.7-782.7) compared to controls (median = 322.1 pg/ml, interquartile range: 277.7-414.4), (P < 0.001). IL-18 level was also significantly higher (P < 0.001) in cases with positive amniotic fluid cultures (median = 697.7, interquartile range: 609.0-847.2) compared to those with negative ones (median = 330.9 pg/ml, interquartile range: 235.2-440.8).ConclusionsElevated mid-trimester concentrations of AF IL-18 can identify women at risk for intraamniotic infection and spontaneous PTD.