Amniotic fluid intercellular adhesion molecule-1 (ICAM -1) concentrations : A marker for impending intraamniotic infection with Ureaplasma and preterm delivery

Abstract

CONCENTRATIONS : A MARKER FOR IMPENDING INTRAAMNIOTIC INFECTION WITH UREAPLASMA AND PRETERM DELIVERY SHULAMITH HOROWITZ, AMNON HADAR, NOA SHANI-SHREM, MOSHE MAZOR, Soroka University Medical Center, Microbiology and Immunology, National Center for Micoplasma, Israel, Beer Sheva, Israel, Soroka University Medical Center, Obstetrics and Gynecology, Beer-Sheva, Israel, Soroka University Medical Center, Obstetrics and Gynecology, Soroka University Medical Center, Beer Sheva, Israel OBJECTIVE: To determine the amniotic fluid ICAM-1 concentrations in women with preterm labor (PTL), according to the presence or absence of intraamniotic (IAI) infection. STUDY DESIGN: Amniotic fluid was obtained by amniocentesis from 132 women with PTL and the samples were examined for ICAM-1 concentrations and for intraamniotic infection with Ureaplasmas and other, less frequent, bacteria. Sixty eight women (51.5%) had preterm delivery (PTD) and 64 women had term deliveries. The statistical significance of the categorical variables was analyzed by c test, or Fisher’s exact test, when appropriate. Odds ratios (95% confidence intervals) were calculated. RESULTS: In the PTD group, 46% (31/68) had IAI with Ureaplasmas, compared to 20% (13/64) in the term delivery group (OR = 3.29, 95% CI 1.47.5; P= .002). The value of ICAM-1 used as the diagnostic cutoff was 1300 ng/ ml [as calculated from a Receiver Operating Characteristic (ROC) curve]. In women with PTD with IAI, 26% (8/31) had ICAM-1 levels above 1300ng/mL whereas none (0/37) in the PTD group without IAI attained this diagnostic level ( P= .001). In parturients with term delivery, there was no significant difference between those with or without IAI, (15% [2/13] had ICAM-1 >1300 ng/mL, compared with 3.9% [2/51], respectively [OR = 4.45, 95% CI 0.4-51.7; P = .13]). CONCLUSION: Amniotic fluid ICAM-1 concentrations exceeding 1300ng/mL might be used as a marker for IAI with Ureaplasma in patients with PTL.