507: Intraamniotic inflammatory response to bacteria in preterm prelabor rupture of membranes pregnancies: analysis of multiple amniotic fluid proteins

Abstract

507 Intraamniotic inflammatory response to bacteria in preterm prelabor rupture of membranes pregnancies: analysis of multiple amniotic fluid proteins Marian Kacerovsky, Kristin Skogstrand, David Hougaard, Ali Khatibi, Bo Jacobsson University Hospital Hradec Kralove, Department of Obstetrics and Gynecology, Hradec Kralove, Czech Republic, Statens Serum Institut, 3Department of Clinical Biochemistry and Immunology, Copenhagen, Denmark, Statens Serum Institut, Department of Clinical Biochemistry and Immunology, Copenhagen, Denmark, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Goteborg, Sweden, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden OBJECTIVE: To analyze whether intraamniotic inflammatory response to bacteria is dependent on gestational age in preterm prelabor rupture membrane (PPROM) pregnancies with using a panel specific proteins. To determine whether is the difference in intraamniotic inflammatory response to genital mycoplasmas and other bacteria. STUDY DESIGN: A prospective follow-up study was performed and 115 women with singleton pregnancies complicated by preterm prelabor rupture of membranes at gestational age between 24 0 and 36 6 weeks were recruited. Amniotic fluid retrieved by transabdominal amniocentesis was analyzed with polymerase chain reaction for genital mycoplasmas, and cultured for aerobic and anaerobic bacteria. The concentrations of 26 proteins in the amniotic fluid were determined simultaneously using multiplex technology. RESULTS: The presence of bacteria in amniotic fluid was found in 43% (49/115) women. The women were stratified into three subgroups according to gestational age. The differences of amniotic fluid proteins between cohorts with and without bacteria were found in the groups with gestational age 24 0 32 0 weeks and 32 1 34 0 for six specific proteins (interleukin 6, 8, 10, granulocyte macrophage colony stimulating factor, monocyte chemotactic protein-1, and macrophage inflammatory protein-1 ) and two proteins (adiponectin, leptin), respectively. No differences were found between women with the presence of genital mycoplasmas and other bacteria in amniotic fluid. CONCLUSION: The intraamniotic inflammatory response to bacteria in amniotic fluid is dependent on gestational age. There is no difference in the intensity of intraamniotic inflammatory response to genital mycoplasmas and the other bacteria. 508 Working conditions and preterm birth in multiple pregnancies Marjo van Melick Dutch Consortium for Studies in Women’s Health and Reproductivity, Department of Obstetrics & Gynaecology, Maastricht, Netherlands OBJECTIVE: Multiple pregnancies are at high risk for preterm birth. Unfortunately, strategies for preventing preterm birth have been largely unsuccessful. Specific physical activities or working conditions are suspected for having an increased effect on preterm birth. The aim of this study was to perform an explorative analysis of the effect of specific work strain in the first 20 weeks of pregnancy on the occurrence of preterm birth in multiple pregnancies before 34 weeks of gestation. STUDY DESIGN: A prospective cohort study was conducted in the Netherlands alongside the multicentre randomized controlled trial ‘Pessaries in multiple pregnancies as a prevention of preterm birth (ProTWIN trial)’. Participants in the ProTWIN trial received questionnaires concerning their working conditions and physical work strain. From these questionnaires specific working conditions of women in the first 20 weeks of pregnancy could be assessed. We assessed whether these conditions were associated with preterm birth before 34 weeks of gestation. RESULTS: Of the 81 participants, 70 (86%) had a paid employment with a mean of 31 working hours per week (range 8-48 hours). The average gestational age at birth in women with and without paid employment was 34 weeks (p 0.79). There were 21 women that delivered before 34 weeks, 17 (81%) of them had a paid employment. Work containing repetitive movements was associated with preterm birth (OR 3.0, 95% CI 1.3 to 6.6). Walking, standing, sitting down, bending over and reaching as well as strenuous work, the need for physical power and an uncomfortable posture were not associated with preterm birth. CONCLUSION: Women with multiple pregnancies and paid employment with heavy physical work strain appear not to be more at risk for preterm birth before 34 weeks of gestation. However, work containing repetitive movements is associated with preterm birth in multiple pregnancies.